Diagnostic performance of ankle ultrasound for diagnosing anterior talofibular and calcaneofibular ligament injuries: a meta-analysis

Seok, Ho-Sik; Lee, Sun Hwa; Yun, Seong Jong

doi:10.1177/0284185119873119

Cited by 16 publications

(15 citation statements)

References 46 publications

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“…Systematic reviews have found USI to be reliable and accurate in the diagnosis of ATFL and calcaneofibular ligament injuries. 48,266,385,386 Specific studies have supported USI with stress testing 150,314 to be useful to further assess the ATFL to identify the type of injury, 44 grade severity of injury, 63 and assess its thickness. 284 Another systematic review found USI to be accurate in identifying foot fractures, 53 and specifically fifth metatarsal, lateral malleolus, and medial malleolus fractures, in those with a foot and/or ankle sprain.…”

Section: Evidence Update and Summarymentioning

confidence: 99%

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

Journal of Orthopaedic & Sports Physical Therapy

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B Clinicians should include patient age, body mass index, pain coping strategies, report of instability, history of previous sprain, ability to bear weight, pain with weight bearing, ankle dorsiflexion range of motion (ROM), medial jointline tenderness, balance, and ability to jump and land (as safely tolerated) in their initial assessment, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with an acute lateral ankle sprain (LAS). CLINICAL COURSE -CHRONIC ANKLE INSTABILITYC Clinicians may include previous treatment, number of sprains, pain level, and self-report of function in their evaluation, as well as an assessment of the sensorimotor movement systems of the foot, ankle, knee, and hip during dynamic postural control and functional movements, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with chronic ankle instability (CAI). DIAGNOSIS/CLASSIFICATION -ACUTE LATERAL ANKLE SPRAINB Clinicians should use special tests, including the reverse anterolateral drawer test and anterolateral talar palpation in addition to the traditional anterior drawer test, and a thorough history and physical examination to aid in the diagnosis of a LAS. DIAGNOSIS/CLASSIFICATION -CHRONIC ANKLE INSTABILITYB When determining whether an individual has CAI, clinicians should use a reliable and valid discriminative instrument, such as the Cumberland Ankle Instability Tool or the Identification of Functional Ankle Instability, as well as a battery of functional performance tests that have established validity to differentiate between healthy controls and individuals with CAI. EXAMINATION -OUTCOME MEASURESA Clinicians should use validated patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System physical function and pain interference scales, the Foot and Ankle Ability Measure, and the Lower Extremity Functional Scale, as part of a standard clinical examination. Clinicians should utilize these before and 1 or more times after the application of interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with an acute LAS or CAI.C Clinicians may use the Pain Self-Efficacy Questionnaire in the acute and postacute periods after a LAS to assess effective coping strategies for pain, and the 11-item Tampa Scale of Kinesiophobia and the Fear-Avoidance Beliefs Questionnaire to assess fear of movement and reinjury and fear-avoidance beliefs in those with CAI. EXAMINATION -PHYSICAL IMPAIRMENT MEASURESA Clinicians should assess and document ankle swelling, ROM, talar translation, talar inversion, and single-leg balance in patients with an acute LAS, postacute LAS, or CAI at baseline and 2 or more times over an episode of care. Clinicians should specifically include measures of dorsiflexion, using the weight-bearing lunge test, static single-limb balance on a firm surface with eyes...

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Section: Evidence Update and Summarymentioning

confidence: 99%

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

Journal of Orthopaedic & Sports Physical Therapy

View full text Add to dashboard Cite

show abstract

“…The sensitivity and specificity of chronic ATFL cases were 98.7% and 94.0%, both better than those of acute ATFL cases at 88.6% and 90.3%, respectively. Radwan et al reported that US can accurately distinguish the degree of ankle sprain and ligament relaxation, ligament tear, ligament thickness, absorbed ligament, and nonunion avulsion fracture, indicating that US is a reliable method for diagnosing CAI and classifying the degree of instability (35). In another systematic review involving 10 articles, both the sensitivity and specificity of US were in the range of 90%–100% (36).…”

Section: Discussionmentioning

confidence: 99%

Imaging diagnosis for anterior talofibular ligament injury: a systemic review with meta-analysis

et al. 2022

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A definite diagnosis of ankle ligament injury is crucial, and many imaging examinations can be used. This review systematically analyzed the effectiveness of various examination methods in the diagnosis of anterior talofibular ligament (ATFL) injuries. Three English databases (PubMed, Embase, and Cochrane Library) and three Chinese databases (CNKI, VIP Database, and Wanfang Database) were searched and relevant studies were summarized. A total of 25 randomized controlled trials met the selection criteria, including six, 16, and three studies recruiting patients with acute, chronic, and both acute and chronic ATFL injuries, respectively. A total of 1409 participants were included. The pooled sensitivity rates of acute ATFL injuries were 82.1% (77.1%–86.5%) by magnetic resonance imaging (MRI) and 88.6% (82.0%–93.5%) by ultrasonography (US). The pooled sensitivity rates of chronic ATFL injuries were 86.3% (82.5%–89.5%) by MRI, 98.7% (95.3%–99.8%) by US, 74.4% (63.6%–83.4%) by stress radiography, and 100% (87.7%–100.0%) for MR arthrography. The pooled specificity rates of acute ATFL injuries were 37.8% (29.1%–47.2%) by MRI and 90.3% (80.1%–96.4%) by US. The pooled specificity rates of chronic ATFL injuries were 86.8% (81.3%–91.2%) by MRI, 94.0% (85.4%–98.3%) for US, 89.4% (76.9%– 96.5%) by stress radiography and 100% (54.1%–100.0%) by MR arthrography. In conclusion, US may be a valuable imaging technique with high sensitivity for diagnosing chronic lateral ankle ligament injuries.

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“…in 2019, the average sensitivity and specificity of ankle ultrasound were 95% and 99%, respectively. [ 23 ] It means that, in case of an injury or lack thereof in the CFL, sonography is capable of providing a reliable diagnosis. Considering the positive and negative predictive values of 50% and 100% for sonography, it can be said that a sonography scan can be as useful as an MRI in detecting or rejecting the rupture cases in the CFL.…”

Section: Methodsmentioning

confidence: 99%

Sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury

et al. 2021

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Background: This study was performed to determine the sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury in comparison with magnetic resonance imaging (MRI). Materials and Methods: This cross-sectional study was performed on 31 patients with soft-tissue injury or fracture, referring to the MRI imaging center of Alzahra and Kashani Hospitals in Isfahan from October 2018 to March 2019. After an MRI, an ultrasound of the affected ankle was performed for all patients. Sonography and MRI were performed by two radiologists who were blinded to the results of each other's reports. The sensitivity, specificity, positive predictive value, and negative predictive value of sonography were determined. Results: In this study, 31 patients with ankle trauma were studied. The mean age of the patients was 30.73 ± 10.15 years; 32.3% were male and 67.7% were female. The sensitivity of ultrasound relative to MRI to detect damage to the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), and calcaneofibular ligament (CFL) was 66.67%, 50%, and 100%, respectively, and the corresponding specificity was 92.86%, 93.10%, and 93.10%, respectively. According to Kappa test, the agreement between ultrasound and MRI methods for detecting injury to ATFL (κ = 0.51), PTFL (κ = 0.35), and CFL (κ= 0.63) was statistically significant ( P < 0.05). Conclusion: Ultrasound is an appropriate modality for the diagnosis of injuries to CFL and ATFL and has shown acceptable results for PTFL. It could be used as an alternative in cases where access to MRI is not available.

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Diagnostic performance of ankle ultrasound for diagnosing anterior talofibular and calcaneofibular ligament injuries: a meta-analysis

Cited by 16 publications

References 46 publications

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Imaging diagnosis for anterior talofibular ligament injury: a systemic review with meta-analysis

Sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury

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