Association between anterior talofibular ligament injury and ankle tendon, ligament, and joint conditions revealed by magnetic resonance imaging

Casado-Hernández, Israel; Becerro‐de‐Bengoa‐Vallejo, Ricardo; Losa‐Iglesias, Marta Elena; Santiago-Nuño, Fernando; Mazoteras‐Pardo, Victoria; López‐López, Daniel; Rodríguez‐Sanz, David

doi:10.21037/qims-20-5

Cited by 9 publications

(13 citation statements)

References 47 publications

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“…Furthermore, an oblique PDw sequence was measured with a matrix of 448 px × 359 px; a TR of 1800 ms; a TE of 29 ms; a slice thickness of 2.5 mm; and a 45° angulation with respect to the tibial plafond [ 7 , 8 , 9 ]. Patients were scanned at a 1.5-T field strength (Magnetom Aera; Siemens Healthineers, Erlangen, Germany).…”

Section: Methodsmentioning

confidence: 99%

“…The most affected ligament is the anteroinferior tibiofibular ligament (AITFL), whereas the involvement of the posteroinferior tibiofibular ligament commonly exhibits a pattern of bony avulsion [8]. Moreover, associated ankle injuries, for example, to the calcaneofibular ligament, are displayed more often in case of AITFL injury [9], potentially resulting in peroneal muscle atrophy [10] and ankle instability [11]. To reliably evaluate the tibiofibular syndesmosis, magnetic resonance imaging (MRI) is the method of choice [6].…”

Section: Introductionmentioning

confidence: 99%

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Scanned versus Fused-Reconstructed Oblique MR-Images for Assessment of the Tibiofibular Syndesmosis—Diagnostic PerFormance and Reader Agreement

et al. 2021

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To evaluate the diagnostic performance and reader agreement of a novel MRI image fusion method enabling the reconstruction of oblique images for the assessment of the tibiofibular syndesmosis. We evaluated 40 magnetic resonance imaging examinations of patients with ankle sprains (16 with ruptures and 24 without) for the presence of anteroinferior tibiofibular ligament rupture. For all patients, we performed a fusion of standard two-dimensional transversal and coronal 3 mm PDw TSE images into an oblique-fusion reconstruction (OFR) and compared these against conventionally scanned oblique sequence for the evaluation of the tibiofibular syndesmosis. To evaluate diagnostic performance, two expert readers independently read the OFR images twice. We analyzed sensitivity, specificity, negative and positive predictive values, accuracy, and agreement. Reader 1 misinterpreted one OFR as a false negative, demonstrating a sensitivity of 0.94 and specificity of 1.00, reader 2 demonstrated perfect accuracy. Intrareader agreement was almost perfect for reader 1 (α = 0.95) and was perfect for reader 2 (α = 1.00). Additionally, interreader agreement between all fusion sequence reads was almost perfect (α = 0.97). The proposed OFR enables reliable detection of anteroinferior tibiofibular ligament rupture with excellent inter- and intrareader agreement, making conventional scanning of oblique images redundant and supplies a method to retroactively create oblique images, e.g., from external examinations.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Scanned versus Fused-Reconstructed Oblique MR-Images for Assessment of the Tibiofibular Syndesmosis—Diagnostic PerFormance and Reader Agreement

et al. 2021

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“…Lateral ankle ligament complex injuries (anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL)) are present in up to 85% of ankle sprains, making them the most frequently injured ligaments secondary to strong ankle inversion movement during lateral ankle sprains [5]. PTFL injury is infrequent, on the other hand, ATFL is considered as the principal injured ligament followed by the CFL [5,6].…”

Section: Introductionmentioning

confidence: 99%

The Role of Diffusion Weighted MR Imaging in the Diagnosis of Tendon Injuries of the Ankle and Foot

Aydın¹,

Kızılgöz

Ersan

et al. 2022

Medicina

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Background and objectives: Our aim is to determine the diagnostic performance and utility of Diffusion Weighted MR Imaging (DWI) against the routine Magnetic Resonance Imaging (MRI) for the evaluation of patients with tendon injuries of the ankle and foot. Materials and Method: After institutional review board approval and informed consent taken from all the patients, ankle and foot MR imaging and DWI-Apparent Diffusion Coefficient (ADC) mapping were performed on the 81 injured tendons of 50 patients. All tendon injuries were named as Rupture (R), Partial tear (PT), and Tenosynovitis (T). Diagnostic interpretation was based on the MRI-DWI and ADC mapping, verified by either open surgery, diagnostic arthroscopy, or conservative procedures-splint application. Statistical analysis of this research was assessed by Fischer’s exact test, variance analysis test between dependent groups, Receiver Operating Characteristics (ROC) curve, and Pearson chi square statistics. Results: MRI depicted all tendon injuries with 70% sensitivity and 100% specificity, and showed a significant statistical relationship to surgical and arthroscopic references with high agreement (p < 0.05, k: 0.609). DWI had 100% sensitivity and 83–90% specificity for the visualization of tendon injuries with certain agreement and a significant statistical relationship to the gold standard (p < 0.05, k: 0.890–0.899). For all those injured tendons, DWI had 100% sensitivity for the diagnosis of R, and 92–97% sensitivity corresponding to PT and T over routine ankle MR imaging. The specificity of DWI to MRI ranged from 75 to 44% for all the injured tendons. DWI had significant statistical superiority over MRI for the visualization of R, PT, and T of all tendons included in this research (p < 0.05). Conclusions: DWI is a good imaging modality for the visualization of ankles with tendon injuries, possibly further improving the sensitivity of the classical ankle and foot MRI, and supplying more beneficial and diagnostic information than routine MR imaging on the basis of R, PT, and T of tendons at the ankle and foot.

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“…Destruction of the joint due to septic arthritis results in functional instability and changes in lower limb muscle activity patterns during unexpected disturbances, particularly in proximal muscles rather than distal muscles [ 12 ]. In addition, according to a study by Casado-Hernández et al [ 13 ], patients with anterior talofibular ligament (ATFL) injuries showed a greater presence of calcaneofibular ligament and tibiotalar joint injuries than subjects with non-injured. These constitute the rationale that functional instability can lead to more severe joint destruction, which accelerates the patient’s limping and pain and intensifies discomfort.…”

Section: Introductionmentioning

confidence: 99%

Staged Joint Arthrodesis in the Treatment of Severe Septic Ankle Arthritis Sequelae: A Case Report

Hong

Jung

Chang

et al. 2021

IJERPH

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Septic ankle arthritis is a devastating clinical entity with high risks of morbidity and mortality. Prompt treatment is necessary because delayed or inadequate treatment can lead to irreversible damage that may occur on the articular surface, resulting in cartilage erosion, infective synovitis, osteomyelitis, joint deformity, and pain and joint dysfunction. An aggressive surgical approach is required when a joint infection causes severe limb-threatening arthritis. A 58-year-old woman visited our clinic with increasing pain in the right ankle, which had been present for the previous 2 months. She complained of discomfort in daily life due to deformity of the ankle; limping; and severe pain in the ankle even after walking a little. The patient reported a history of right-ankle injury while exiting a bus in her early 20s. Plain radiographs of the right ankle joint revealed that the medial malleolus was nearly absent in the right ankle joint on the anteroposterior view, and severe varus deformity was observed with osteoarthritic changes because of joint space destruction. Magnetic resonance imaging revealed diffuse synovial thickening of the destroyed tibiotalar joint with joint effusion. Hybrid 99mTc white blood cell single-photon emission computed tomography/computed tomography showed increased uptake along the soft tissue around the ankle joint; uptake was generally low in the talocrural and subtalar joints. A two-stage operation was performed to remove the infected lesions and correct the deformity, thus enabling limb salvage. The patient was nearly asymptomatic at the 6-month follow-up, with no discomfort in her daily life and nearly normal ability to carry out full functional activities. She had no complications or recurrent symptoms at the 1-year follow-up. We have described a rare case of a staged limb salvage procedure in a patient with chronic septic arthritis sequelae. For patients with severe joint deformity because of septic ankle sequelae, staged arthrodesis is a reliable method to remove infected lesions, solve soft tissue problems, correct deformities, and maintain leg length.

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Association between anterior talofibular ligament injury and ankle tendon, ligament, and joint conditions revealed by magnetic resonance imaging

Cited by 9 publications

References 47 publications

Scanned versus Fused-Reconstructed Oblique MR-Images for Assessment of the Tibiofibular Syndesmosis—Diagnostic PerFormance and Reader Agreement

Scanned versus Fused-Reconstructed Oblique MR-Images for Assessment of the Tibiofibular Syndesmosis—Diagnostic PerFormance and Reader Agreement

The Role of Diffusion Weighted MR Imaging in the Diagnosis of Tendon Injuries of the Ankle and Foot

Staged Joint Arthrodesis in the Treatment of Severe Septic Ankle Arthritis Sequelae: A Case Report

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