Ultrasound Assessment of the Anterolateral Ligament of the Knee: A Narrative Review of Current Evidence, Interpretative Limitations, and Clinical Context

Rotational knee instability remains a relevant clinical problem, particularly in patients with anterior cruciate ligament injury, and has renewed interest in the anterolateral ligament (ALL) as a contributing structure. This narrative review critically synthesizes current anatomical, biomechanical, and ultrasonographic evidence regarding the ALL, with emphasis on the interpretative capabilities and limitations of musculoskeletal ultrasound. Available data indicate that ultrasound allows anatomical identification of the ALL, primarily in asymptomatic populations, but does not support its use as a standalone diagnostic tool for ALL injury. Dynamic ultrasound approaches remain observational, non-standardized, and lack clinical validation. Ultrasound may be considered only as a complementary modality within a clearly defined clinical context.