Accuracy of magnetic resonance imaging in diagnosing lateral ankle ligament injuries: A comparative study with surgical findings and timings of scans

Abstract

ObjectiveThis study aimed to evaluate the accuracy of magnetic resonance imaging (MRI) in diagnosing lateral ankle ligament injuries and the effect of differences in time duration from injury to MRI.MethodsData were collected prospectively from 82 patients who underwent MRI and lateral ligament reconstruction, and were divided into either acute (≤3 months) or chronic (>3 months) group based on injury interval. Findings were classified as normal, partial, or complete tears of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). MRI results were compared with intraoperative findings and their accuracies were assessed using descriptive statistics.ResultsThe accuracy of MRI for partial and complete tears of the ATFL was 74% and 79%, respectively, with sensitivity and specificity of 64% and 86% for partial tears, and 78% and 80% for complete tears, respectively. The accuracy of MRI was 66% and 88% for partial and complete tears of the CFL with a sensitivity and specificity of 41% and 87% for partial tears, and 61% and 95% for complete tears, respectively. A decrease in the MRI accuracy was observed in the chronic group.ConclusionMRI is accurate in diagnosing ATFL injuries. It is specific but not sensitive for CFL tears. The accuracy is higher in the acute setting of 3 months or less from time of injury to MRI.

Imaging diagnosis for chronic lateral ankle ligament injury: a systemic review with meta-analysis

“…Overall, 15 studies [ 35 – 49 ] were eligible for this systemic review and are summarized in Table 2 . A total of 695 participants were included.…”

“…A total of 695 participants were included. In 3 studies [ 39 , 45 , 49 ], participants were divided into acute injury group and chronic injury one, chronic injury groups of which were included in data synthesis. Two studies [ 42 , 44 ] reported inter-rater reliability.…”

“…2 ). All studies mentioned that participants were diagnosed of chronic ligament injury, of which 9 studies [ 36 – 38 , 42 , 43 , 45 , 46 , 48 , 49 ] mentioned the time from initial ankle inversion trauma to study commencement or duration when patients presented with chronic symptoms. Six of 15 studies [ 35 , 38 , 39 , 41 , 44 , 47 ] were categorized as high risk of bias due to patient selection.…”

Evaluation of the anterior inferior tibiofibular and anterior talofibular ligaments using 2D oblique coronal imaging and 3D isotropic resolution T2‐weighted fast spin‐echo sequences at 3.0 T: Is there additional diagnostic value?

“…Most syndesmosis injuries arise from external rotation of the ankle; among the four ligaments, it is most important to evaluate the AiTFL 6,7 . There have been many attempts to accurately evaluate the pathology of AiTFL and ATFL using MRI 4,8‐12 . There is still a question about the usefulness of the routine ankle MRI protocol for diagnosis of AiTFL and ATFL injury because of the variable diagnostic accuracy.…”

“…There is still a question about the usefulness of the routine ankle MRI protocol for diagnosis of AiTFL and ATFL injury because of the variable diagnostic accuracy. MRI sensitivity is about 40–95% and its specificity is 70–97%, which is a wide range 4,9‐11,13‐16 . The reason for this variable diagnostic accuracy may be associated with anatomical features of lateral ankle ligaments.…”