Spring Ligament Tear: The Coronal MRI Contact Sign

On coronal MRI, direct contact between the posterior tibial tendon and the talar head indicates a tear of the superomedial spring ligament — a fast, reliable imaging finding.

• The sign relies on loss of the normal interposed ligament fibers, allowing the tendon to abut the talar head.
• This is a teaching pearl for rapid identification; formal sensitivity/specificity numbers are not provided.
• Limited to the superomedial component; does not assess the inferoplantar portion of the ligament complex.

RadPigeon summaries are original and for information only. They are not clinical advice.