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

Abstract

BackgroundVarious imaging techniques have been utilized for the diagnosis of chronic lateral ankle ligament injury. This systemic review will explore the effectiveness of different imaging techniques in diagnosing chronic lateral ankle ligament injury.MethodsRelative studies were retrieved after searching 3 databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. Data were extracted to calculate pooled sensitivity and specificity of magnetic resonance imaging (MRI), ultrasonography (US), stress radiography, and arthrography.ResultsFifteen studies met our inclusion and exclusion criteria. A total of 695 participants were included. The pooled sensitivities in diagnosing chronic ATFL injury were 0.83 [0.78, 0.87] for MRI, 0.99 [0.96, 1.00] for US, and 0.81 [0.68, 0.90] for stress radiography. The pooled specificities in diagnosing chronic ATFL injury were 0.79 [0.69, 0.87] for MRI, 0.91 [0.82, 0.97] for US, and 0.92 [0.79, 0.98] for stress radiography. The pooled sensitivities in diagnosing chronic CFL injury were 0.56 [0.46, 0.66] for MRI, 0.94 [0.85, 0.98] for US, and 0.90 [0.73, 0.98] for arthrography. The pooled specificities in diagnosing chronic CFL injury were 0.88 [0.82, 0.93] for MRI, 0.91 [0.80, 0.97] for US, and 0.90 [0.77, 0.97] for arthrography.ConclusionThis systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of chronic lateral ankle ligament injury. Ultrasound manifested high diagnostic accuracy in diagnosing chronic lateral ankle ligament injury. Clinicians should be aware of the limitations of MRI in detecting chronic CFL injuries.

Ankle Joint Injuries Accompanying Fifth Metatarsal Base Fractures

“…Khor et al evaluated 64 consecutive patients' ankle MRI findings who had ankle sprain as a result of inversion mechanism (13). As expected, most common MRI finding was observed as anterior talofibular ligament injury (ATFL) (75%).…”

“…Physical examination is the first step in diagnosing the ankle injuries however, additional imaging studies are required frequently (13). Although conventional radiographic examinations are useful for detecting bone pathologies, they are insufficient to determine injuries about soft tissues, cartilage and trabecular bone.…”

“…Although conventional radiographic examinations are useful for detecting bone pathologies, they are insufficient to determine injuries about soft tissues, cartilage and trabecular bone. Arthrography, ultrasonography, computed tomography (CT) and MRI are all useful tools for the diagnosis (13). CT is the most useful imaging tool for assessing bone fractures, especially for the intraarticular ones both for evaluation and preoperative planning.…”

“…CT is the most useful imaging tool for assessing bone fractures, especially for the intraarticular ones both for evaluation and preoperative planning. However, the possible hazards of the radiation is the major concern while using CT. Our secondary radiologic diagnostic tool was magnetic resonance imaging because it was sensitive both for pathologies of soft tissue-trabecular bone-cartilage and occult bone injuries of the talocrural joint (13,14). Because of these reasons we did not use CT imaging.…”

Lateral Ankle Sprain and Chronic Ankle Instability

“…11 The accuracy of MRI was mostly limited to diagnosing chronic ATFL injuries (pooled sensitivity of 0.83). 11 These findings suggest that imaging alone is insufficient to diagnose CAI. However, MRI is still valuable to assess for talar or tibial osteochondral damage ( Figure 6A) if a patient continues to have persistent ankle pain after conservative treatment.…”