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increased amount of synovial fluid, that may occur with inflammation, infection or trauma. On a lateral ankle radiograph fluid within the anterior or posterior recess is seen as increased soft tissue density immediately adjacent to the joint. This is often most prominent anteriorly where it appears as a teardrop-shaped soft tissue density outlined by an anteriorly displaced or bowed fat plane (Fig.1). Ultrasound provides a more sensitive means of detecting ankle joint effusions. Sonographically the fluid is best visualized anteriorly but may also be demonstrated within the posterior recess. The juxtarticular tendons often communicate with the ankle joint cavity and therefore the ankle effusion may "decompress" into the adjacent tendon sheaths and cause distension of the tendon sheaths in the absence of a true tenosynovitis. See effusion
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The Encyclopaedia of Medical Imaging Volume VII
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Ankle joint effusion, Fig. 1 Lateral radiograph of the ankle. The joint effusion is seen as a soft tissue teardrop-shaped density displacing the anterior fat pad.
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