Private Ankle Ultrasound Scan

Ankle injuries and conditions affect the ligaments, tendons, nerves, and joint of the ankle — one of the most commonly injured joints in the body. Injuries can be acute (sudden ankle sprains, Achilles tears) or chronic (Achilles tendinopathy, peroneal tendon tears, tibialis posterior tendinopathy from progressive overuse).

A private ankle ultrasound is a quick, safe, pain-free diagnostic test using high-frequency sound waves to produce real-time images of the ankle soft tissue structures. Common causes of ankle pain that ultrasound can identify include:

• Achilles tendinopathy or tear — most common in runners, middle-aged adults, and those returning from inactivity
• Lateral ankle ligament sprain (ATFL) — the most commonly injured ligament in the body; 85% of ankle sprains involve the ATFL
• Peroneal tendon tears and subluxation — outer ankle pain, especially with eversion weakness
• Tibialis posterior tendinopathy — medial ankle pain and progressive flat foot
• Retrocalcaneal bursitis — posterior heel swelling and pain, often with Haglund’s deformity
• Syndesmotic injury (high ankle sprain) — more significant than a standard ankle sprain; easy to miss without imaging
• Tarsal tunnel syndrome — tibial nerve compression behind the medial malleolus
• Ankle joint synovitis — from inflammatory arthritis, gout, or post-traumatic changes

A private ankle ultrasound produces real-time images of all major ankle soft tissue structures including:

• Achilles tendon — diameter, intratendinous tears, Doppler neovascularity, retrocalcaneal bursitis, and insertional changes
• ATFL and CFL — ligament integrity, thickening, heterogeneity, and dynamic anterior drawer stress testing for laxity
• Peroneal tendons — longitudinal split tears in peroneus brevis and longus, tenosynovitis, and dynamic subluxation over the lateral malleolus during inversion/eversion
• Tibialis posterior tendon — calibre change (compared to the contralateral side), sheath tenosynovitis, and intratendinous tears
• Tibial nerve at tarsal tunnel — cross-sectional area and compressive pathology
• Ankle joint — effusion, synovitis, Doppler active pannus, and loose bodies
• Syndesmotic ligament (AITFL) — integrity and dynamic diastasis under external rotation stress

Jacobson JA. Ankle and foot ultrasound. AJR Am J Roentgenol 2011;196:1026–34 — comprehensive ankle ultrasound reference. | PMC 2025: MSK ultrasound of the Achilles tendon — sensitivity 96–100%, specificity 83–100% for complete tears.

At London Private Ultrasound, a private ankle ultrasound costs:

• One ankle: £199 — all fees inclusive with no hidden charges
• Both ankles: £299 — saving £99 compared to two separate single-ankle scans

Both options include same-day verbal results and a full written report within 24 hours. We accept all major credit and debit cards, cash, and Klarna. If you also need foot assessment, our combined foot and ankle scan is available at £299 (one side) and £499 (both sides).

Yes. Ankle ultrasound is highly accurate for Achilles tendon assessment, with sensitivity of 96–100% and specificity of 83–100% for complete Achilles tendon tears. It can detect:

• Complete tears — a gap between the tendon ends with haematoma; the Thompson squeeze test can be correlated under ultrasound
• Partial tears — focal hypoechogenicity and fibre disruption without complete discontinuity
• Mid-portion tendinopathy — tendon thickening, diffuse or focal hypoechoic change, intratendinous tears, and Doppler neovascularity indicating chronic degeneration
• Insertional tendinopathy — calcification, fibrocartilaginous change, and retrocalcaneal bursitis at the calcaneal attachment

If a complete Achilles rupture is suspected — sudden “pop” at the back of the ankle with immediate inability to push off or stand on tiptoe — please call 020 7101 3377 for same-day urgent assessment. Surgical timing is critical.

PMC 2025: MSK ultrasound of the Achilles tendon — sensitivity 96–100%, specificity 83–100% for complete tears.

Yes. Ankle ultrasound accurately assesses the lateral ankle ligament complex — the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). It can:

• Identify ATFL tears: Ligament thickening, heterogeneity, and focal fibre disruption indicating partial or complete tear
• Perform dynamic anterior drawer stress testing: The ankle is stressed in a controlled manner during ultrasound imaging, measuring tibiotalar joint translation in real time — this distinguishes a stable Grade 1 sprain from a Grade 2–3 tear with functional instability, which standard clinical examination often cannot do accurately in the acute phase
• Assess the CFL: The calcaneofibular ligament is visualised behind the peroneal tendons and can be assessed for integrity following more significant inversion injuries

The ATFL is the most commonly injured ligament in the human body, accounting for approximately 85% of all ankle sprains. Most lateral ligament sprains heal with physiotherapy, but persistent instability or Grade 3 complete tears in active patients may benefit from surgical repair or reconstruction — a decision informed by accurate ultrasound assessment.

Yes — and this is one of the most compelling advantages of ankle ultrasound over MRI. Peroneal tendon subluxation is a condition where the peroneal tendons snap over the lateral malleolus during ankle movement, caused by a torn or lax superior peroneal retinaculum. This is a dynamic finding — it only occurs during movement — and is therefore completely invisible on static MRI.

Under ultrasound, the examiner can observe the peroneal tendons in real time during active ankle inversion and eversion, directly demonstrating the subluxation event as it occurs. This single finding often determines the treatment pathway: confirmed subluxation in an active patient typically leads to surgical retinaculum repair, while a stable retinaculum allows conservative management of the underlying peroneal tendon tear.

See a doctor if you experience:

• Ongoing ankle pain that has not improved after 2–4 weeks of rest and simple pain management
• Posterior ankle pain and stiffness in the morning or after activity (possible Achilles tendinopathy)
• Outer ankle pain and eversion weakness after a twisting injury
• Inner ankle pain with progressive flattening of the arch (possible tibialis posterior tendinopathy)
• Ankle that feels unstable or gives way on uneven ground after a previous sprain
• A snap or click felt behind the lateral malleolus during ankle movement

Seek urgent assessment if you have:

• A sudden “pop” at the back of the ankle followed by inability to push off or rise on tiptoe — suspected Achilles tendon rupture requiring urgent imaging. Call 020 7101 3377 for same-day availability
• Severe ankle swelling and inability to weight-bear after trauma — possible fracture; X-ray should be the first investigation
• Heat, redness, and rapid swelling of the ankle joint — possible septic arthritis or acute gout requiring same-day medical assessment

An ankle ultrasound is a quick and easy way to diagnose many causes of ankle pain. There is no preparation required. We recommend wearing loose trousers or shorts so the lower leg and ankle are easily accessible from all four sides — posterior, medial, lateral, and anterior. Remove any ankle jewellery before your appointment.

You will sit or lie comfortably on the examination table. Your specialist applies a clear, water-based gel to the ankle and moves the probe gently over the skin surface — entirely painless. During the dynamic assessment, you will be asked to flex and extend the ankle, perform inversion and eversion movements, and hold specific positions to allow ligament stress testing and peroneal tendon subluxation assessment. The scan typically takes 25–35 minutes for a thorough ankle assessment. Your specialist provides findings verbally immediately afterwards.

No preparation is required. You may eat, drink, and take medications normally. Wear loose trousers, shorts, or easily removed socks so your lower leg and ankle are fully accessible. Remove any ankle or toe jewellery, ankle braces, compression socks, and strapping before arriving. No fasting or medication changes are needed.

There is no aftercare required. You may resume all normal activities immediately unless your specialist advises otherwise. There are no confirmed adverse biological effects from diagnostic ultrasound.

Your specialist explains findings verbally immediately after the scan. Depending on results, they may recommend physiotherapy, activity modification, orthotic support, a guided injection, or further imaging. If your scan identifies a significant finding requiring urgent NHS orthopaedic attention — a complete Achilles tear or significant syndesmotic injury — our specialist generates a formal referral letter the same day.

One ankle (£199) is appropriate if symptoms affect one ankle only.

Both ankles (£299, saving £99) is recommended if you have:

• Bilateral Achilles tendinopathy — very common in bilateral distance runners; the contralateral side often shows subclinical tendinopathy that is important to identify and monitor
• Tibialis posterior tendinopathy — comparison with the contralateral side is the key diagnostic step; a bilateral scan provides this comparison within a single appointment
• Bilateral ankle instability in hypermobile patients
• Inflammatory arthritis affecting both ankles (RA, psoriatic, gout) — bilateral Doppler synovitis monitoring
• Pre-surgical symmetry assessment before ankle ligament reconstruction

If unsure, call 020 7101 3377 and our team will advise.

No. You do not require a referral. Book directly online at londonsono.com or call 020 7101 3377. Appointments are available 7 days a week at our Central London clinic (27 Welbeck Street, Harley Street medical district) and our St Albans clinic (54–56 Victoria Street). For suspected Achilles rupture, please call rather than booking online — same-day urgent assessment is available.

Yes. Ultrasound guidance significantly improves accuracy and safety for ankle injections. At London Private Ultrasound, our joint injection clinic offers ultrasound-guided:

• Achilles peritendinous injection — high-volume injection (HVI) or PRP placed in the peritendinous space for mid-portion Achilles tendinopathy; corticosteroid is avoided in the tendon body due to the risk of tendon weakening and rupture
• Retrocalcaneal bursa injection — corticosteroid injected into the bursa between the Achilles and the calcaneus for retrocalcaneal bursitis and insertional tendinopathy
• Ankle joint injection — for inflammatory arthritis, synovitis, gout, or post-traumatic ankle pain
• Peroneal tendon sheath injection — corticosteroid injected into the common peroneal tendon sheath for tenosynovitis
• Tarsal tunnel injection — corticosteroid around the tibial nerve for tarsal tunnel syndrome symptoms

Injection therapy can often be arranged at the same appointment as your diagnostic scan.

Many of our patients are concerned that if they come to us for an ultrasound, they won’t be able to go back to public health. That simply is not the case. Our goal is to give you answers as quickly as possible and get you on the right treatment path fast — no strings attached.

When you come to us, you will be seen by a qualified MSK specialist who can assess your ankle condition the same day. We don’t want you to wait weeks on end for an appointment. If your scan reveals findings requiring urgent NHS attention — a complete Achilles rupture requiring surgical repair, or a significant syndesmotic injury requiring orthopaedic review — our specialist writes a formal referral letter the same day for your GP. We work alongside the NHS, not instead of it.