The distal-most location of the syndesmosis, the ATiFL, is approximately 2.5 cm (1 inch) proximal and slightly medial to the anterior talofibular ligament. There is usually no landmark to palpate, as the tibiotalar joint line and tibiotalar syndesmosis are not distinct in most individuals. A good approach to palpating the syndesmosis is to locate the antero-medial tip of the lateral malleolus (distal fingertip in photo), move proximally about 2.5 cm and slightly medial to the ATiFL (proximal fingertip in photo), and continue palpation proximally along the interosseous membrane.
