The distal syndesmosis is felt by following the medial edge of the fibula superior to the joint line. In this position the talus is slightly externally rotated the lateral gutter of ankle joint is partially obscured by the lateral malleolus and the anterior tubercle of the tibia overlaps the distal fibula. The lateral gutter of the ankle joint can be found by running the thumb medially over the anterior and medial edge of the fibula.
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