Correlation and comparison of syndesmosis dimension on CT and MRI

Wong, Fabian; Mills, Rebecca; Mushtaq, Nadeem; Walker, Roland; Singh, Somendra Pal; Abbasian, Ali

doi:10.1016/j.foot.2016.06.001

Cited by 3 publications

(6 citation statements)

References 22 publications

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“…Moreover, interpreting ankle MRI needs expert radiologists. Wong et al 21 reported wider measurements in the axial section of CT in comparison with MRI of normal ankles which could be due to cartilage thickness revealed clearly in MRI. Hence, in comparison with MRI, this point should be considered.…”

Section: Discussionmentioning

confidence: 99%

“…13 Some have described different measurement methods of dimensions or angles to explain the anatomy of incisura fibularis and positions of the fibula in relation to the incisura fibularis. 8,11,13,[18][19][20] We measured only 3 simple popular constant parameters (anterior width, posterior width, overlap), 11,21 because most of the described techniques are complex measurements with multiple lines and references points. Furthermore, some of them may not be reliable, as we cannot exactly determine the rotation of tibia and fibula without having femoral trans-epicondylar axis.…”

Section: Discussionmentioning

confidence: 99%

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Morphological Variations and Normal Parameters of the Cross-Sectional Anatomy of the Tibiofibular Syndesmotic

Hashemi

Nosrati

Shayan

et al. 2021

Foot & Ankle Specialist

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Background: The aim of this study was to determine morphological variations and normal parameters of the cross-sectional tibiofibular syndesmotic anatomy. Methods: Configurations of syndesmosis, anterior syndesmotic width (ASW), posterior syndesmotic width (PSW), and overlap distance, defined as the overlap of medial fibula with a drawn line from tip of anterior tubercle of incisura fibularis to the posterior tip, were measured on normal computed tomography (CT) scans of 110 cases. Results: Seventy seven male (70%) and 33 female (30%) (left: 50 and right: 60) were assessed. Mean age of the cases was 33 ± 13 (range: 15-80) years. Three different syndesmotic configurations were crescent (55.5%), rectangular (39.1 %), and semicircle (5.4 %). Overall, mean ASW, PSW, and overlap distance were 2.72, 3.98, and 1.02 mm, respectively. Upper limit of normal ASW in crescent, rectangular, and semicircle was 4.80, 4.85, and 3.89 mm, respectively. The maximum of PSW in crescent, rectangular, and semicircle was 6.25, 6.50, and 4.97 mm, respectively. There was not significant difference between syndesmotic configurations based on age (P = .69) and sex (P = .16). Conclusions: During interpreting axial CT scan to diagnose syndesmotic injuries, the normal range of parameters according to the different configurations of the tibiofibular syndesmosis should be carefully considered. Level of Evidence: Level 4

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Morphological Variations and Normal Parameters of the Cross-Sectional Anatomy of the Tibiofibular Syndesmotic

Hashemi

Nosrati

Shayan

et al. 2021

Foot & Ankle Specialist

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“…When the widening does not correlate with clinical findings a contralateral comparative CT or an ipsilateral MRI scan is recommended. 81 MRI has been considered the investigation of choice for suspected syndesmotic ligament injury. 22 It demonstrated a sensitivity of 100% and a specificity of 93% for AITFL injuries and a sensitivity and specificity of 100% for PITFL tears.…”

Section: Investigationsmentioning

confidence: 99%

Instability of the distal tibiofibular syndesmosis

Vohra¹,

Singh²,

Thorat³

et al. 2023

J Orthop Surg (Hong Kong)

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The distal tibiofibular syndesmosis (DTFS) is more frequently injured than previously thought. Early diagnosis and appropriate treatment is essential to avoid long term complications like chronic instability, early osteoarthritis and residual pain. Management of these injuries require a complete understanding of the anatomy of DTFS, and the role played by the ligaments stabilizing the DTFS and ankle. High index of suspicion, appreciating the areas of focal tenderness and utilizing the provocative maneuvers help in early diagnosis. In pure ligamentous injuries radiographs with stress of weight bearing help to detect subtle instability. If these images are inconclusive, then further imaging with MRI, CT scan, stress examination under anesthesia, and arthroscopic examination facilitate diagnosis. An injury to syndesmosis frequently accompanies rotational fractures and all ankle fractures need to be stressed intra-operatively under fluoroscopy after fixation of the osseous components to detect syndesmotic instability. Non-operative treatment is appropriate for stable injuries. Unstable injuries should be treated operatively. Anatomic reduction of the syndesmosis is critical, and currently both trans-syndesmotic screws and suture button fixation are commonly used for syndesmotic stabilization. Chronic syndesmotic instability (CSI) requires debridement of syndesmosis, restoration of ankle mortise with or without syndesmotic stabilization. Arthrodesis of ankle is used a last resort in the presence of significant ankle arthritis. This article reviews anatomy and biomechanics of the syndesmosis, the mechanism of pure ligamentous injury and injury associated with ankle fractures, clinical, radiological and arthroscopic diagnosis and surgical treatment.

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“…The distance between the anterior tibial tubercle and the nearest fibular point. [5,6,13,18,20,[22][23][24][25][26][27][28][29][30][31][32] Posterior tibiofibular width (B)…”

Section: Conventional 2d Measurementsmentioning

confidence: 99%

“…• Anterior, middle, posterior, maximum, and minimum tibiofibular width First described by Gardner et al [25], the anterior tibiofibular width (ATFW) and posterior tibiofibular width (PTFW) are the most commonly used measurements of the distal tibiofibular joint in the literature [5,6,13,18,20,[22][23][24][25][26][27][28][29][30][31][32]. They serve as indicators of diastasis between the tibia and fibula [29].…”

Section: D Measurements Quantifying Tibiofibular Translationmentioning

confidence: 99%

Ins and Outs of the Ankle Syndesmosis from a 2D to 3D CT Perspective

Dhont,

Huyghe,

Peiffer

et al. 2023

Applied Sciences

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Despite various proposed measurement techniques for assessing syndesmosis integrity, a standardized protocol is lacking, and the existing literature reports inconsistent findings regarding normal and abnormal relationships between the fibula and tibia at the distal level. Therefore, this study aims to present an overview of two- (2D) and three-dimensional (3D) measurement methods utilized to evaluate syndesmosis integrity. A topical literature review was conducted, including studies employing 2D or 3D measurement techniques to quantify distal tibiofibular syndesmosis alignment on computed tomography (CT) or weight-bearing CT (WBCT) scans. A total of 48 eligible articles were included in this review. While most interclass correlation (ICC) values indicate favorable reliability, certain measurements involving multiple steps exhibited lower ICC values, potentially due to the learning curve associated with their implementation. Inconclusive results were obtained regarding the influence of age, sex, and height on syndesmotic measurements. No significant difference was observed between bilateral ankles, permitting the use of the opposite side as an internal control for comparison. There is a notable range of normal and pathological values, as evidenced by the standard deviation associated with each measurement. This review highlights the absence of a consensus on syndesmotic measurements for assessing integrity despite numerous CT scan studies. The diverse measurement techniques, complexity, and inconclusive findings present challenges in distinguishing between normal and pathological values in routine clinical practice. Promising advancements in novel 3D techniques offer potential for automated measurements and reduction of observer inaccuracies, but further validation is needed.

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Correlation and comparison of syndesmosis dimension on CT and MRI

Cited by 3 publications

References 22 publications

Morphological Variations and Normal Parameters of the Cross-Sectional Anatomy of the Tibiofibular Syndesmotic

Morphological Variations and Normal Parameters of the Cross-Sectional Anatomy of the Tibiofibular Syndesmotic

Instability of the distal tibiofibular syndesmosis

Ins and Outs of the Ankle Syndesmosis from a 2D to 3D CT Perspective

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