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©2013 UpToDate ® Print Email Ankle arthrocentesis With the leg-foot angle at 90 degrees, the needle is inserted at a point just medial to the tibalis anterior tendon and just lateral to the medial malleolus (arrow). The needle is then directly posteriorly. Reproduced with permission from Owen, DS. Aspiration and injection of joints in soft tissue. In: Textbook of Rheumatology, 4th edition, Kelley, WN, Harris, ED Jr, Ruddy, S, et al (Eds), WB Saunders, Philadelphia 1993. p.545.