Background : the proximal tibiofibular joint is involved in the biomechanics of both knee and ankle.

Its physiological role and the relatively rare pathologies associated with it are not often discussed in scientific literature or clinical practice.

Purpose : this review aims to raise awareness among healthcare professionals of proximal tibiofibular joint's contribution to lower limb function and dysfunction.

Material and methods : We reviewed the literature, acquired a high-resolution MRI study of cadaver knees and extracted radiological manifestations of several clinical cases.

Results : This review provides an anatomical overview of this joint and adjacent structures.

It summarises the joint's main biomechanical principles.

Finally, it presents several clinical cases, and their radiological manifestations, of the most common and emblematic pathologies of this joint and the surrounding structures, as treated at our institution.

Conclusion : The proximal tibiofibular joint is seen in every knee MRI. Therefore, knowledge of its anatomy and variants and their impact on diverse pathologies is important. Our article gives a practical view on these matters.