Inter and intra-examiner reliability of musculoskeletal ultrasound scanning of Anterior Talofibular Ligament and ankle muscles

Özgül, Bahar; Starbuck, Chelsea; Polat, Mi̇ne Gülden; Abdeen, Rawan; Nester, Christopher

doi:10.1007/s40477-022-00699-8

Cited by 3 publications

(4 citation statements)

References 38 publications

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“…The reliability of ultrasound examination of the ATFL is influenced by the device being equipped with a high‐frequency probe and the examiner's experience [22]. However, recent data show high inter/intra‐examiner reliability, even when the examiner's experience is minimal, with only 6 weeks' training being necessary to ensure substantial reliability [48].…”

Section: Discussionmentioning

confidence: 99%

Anterior talofibular ligament's superior fascicle as a cause of ankle microinstability can be routinely identified by ultrasound

Esparó,

Vega,

Cordier

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeChronic pain can affect up to 40% of patients after ankle inversion sprains. The current hypothesis to explain this high percentage of chronic pain is a partial/total rupture of anterior talofibular ligament (ATFL) superior fascicle, a structure that has recently been described as intra‐articular and as having a different function than ATFL's inferior fascicle. This has created the need for diagnosing ATFL superior and inferior fascicles independently. Therefore, the objective of this study is to investigate if the ATFL's superior fascicle can be visualized on ultrasound, and to describe its ultrasonographic appearance.MethodsTwenty fresh‐frozen ankle specimens were used in this 4‐phases study. First, the specimens were scanned on US to identify what was believed to be ATFL's superior fascicle. Second, ATFL's superior fascicle was sutured under direct arthroscopic vision. Next, the specimens were scanned on US to obtain an image of the sutured structure. Finally, the specimens were dissected to confirm that the suture was indeed placed on ATFL's superior fascicle.ResultsOn the 20 specimens studied, full correlation was obtained between US, arthroscopic suture and specimen dissection. ATFL's superior fascicle US appearance is provided.ConclusionATFL's superior fascicle can be visualized on US, which will allow to undergo diagnosis of isolated injuries to that fascicle, a common finding in ankle microinstability. The results of this study will facilitate the diagnosis of partial or complete rupture of ATFL's superior fascicle, likely increasing the amount of ankle microinstability diagnosis, impacting clinical management of ankle sprain consequences.

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Section: Discussionmentioning

confidence: 99%

Anterior talofibular ligament's superior fascicle as a cause of ankle microinstability can be routinely identified by ultrasound

Esparó,

Vega,

Cordier

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…Our results could improve the reliability of ultrasonographic visualization of the ATFL. In previous studies, the anterolateral aspect of the fibula [ 16 , 18 , 21 , 23 , 25 , 26 , 30 ] and FOT [ 5 , 27 ] have been used for ATFL identification during ultrasonography. However, as a bony landmark for ultrasonographic imaging, the anterolateral aspect of the fibula is unspecific and outside the actual ATFL attachment.…”

Section: Discussionmentioning

confidence: 99%

“…Ten feet of five healthy living specimens (average age 25.6 [23][24][25][26][27][28][29][30][31][32][33][34][35] years, 5 women) were investigated. We recruited individuals with no history of previous ankle surgery.…”

Section: Ultrasonographic Imaging In Living Specimensmentioning

confidence: 99%

“…Operative stabilization of the ankle joint has been recommended for patients with CAI to reduce pain and restore function [3,5,[8][9][10][11][12][13][14]. Moreover, ultrasound imaging has been reported as a useful modality for the noninvasive evaluation of torn ligaments in reference to the bony landmarks and the fibrillar pattern of the ligament [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. However, the best imaging method for ATFL evaluation has not been clearly defined, which is of concern because without standardization, the results of evaluations are not repeatable.…”

Section: Introductionmentioning

confidence: 99%

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Anatomical study of the bone morphology of the anterior talofibular ligament attachment

Fujishiro,

Nimura,

Azumaya

et al. 2023

Anat Cell Biol

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Anterior talofibular ligament (ATFL) injuries are the most common cause of ankle sprains. To ensure anatomically accurate surgery and ultrasound imaging of the ATFL, anatomical knowledge of the bony landmarks around the ATFL attachment to the distal fibula is required. The purpose of the present study was to anatomically investigate the ATFL attachment to the fibula with respect to bone morphology and attachment structures. First, we analyzed 36 feet using microcomputed tomography. After excluding 9 feet for deformities, the remaining 27 feet were used for chemically debrided bone analysis and macroscopic and histological observations. Ten feet of living specimens were observed using ultrasonography. We found that a bony ridge was present at the boundary between the attachments of the ATFL and calcaneofibular ligament (CFL) to the fibula. These two attachments could be distinguished based on a difference in fiber orientation. Histologically, the ATFL was attached to the anterodistal part of the fibula via fibrocartilage anterior to the bony ridge indicating the border with the CFL attachment. Using ultrasonography in living specimens, the bony ridge and hyperechoic fibrillar pattern of the ATFL could be visualized. We established that the bony ridge corresponded to the posterior margin of the ATFL attachment itself. The ridge was obvious, and the superior fibers of the ATFL have directly attached anteriorly to it. This bony ridge could become a valuable and easy-to-use landmark for ultrasound imaging of the ATFL attachment if combined with the identification of the fibrillar pattern of the ATFL.

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Correlations Between Imaging and Clinical, Functional and Biological Features in Knee Osteoarthritis

Minea,

Vlădăreanu,

Minea

et al. 2024

Balneo and PRM Research Journal

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Background: For knee osteoarthritis (OA) pathogeny, cartilage damage is important, and ultrasonography (US) is helpful in assessing specific joint issues. Objectives: We intend to find correlations between functionality, pain level, serum glucose, cholesterol, triglycer-ides, uric acid, systemic inflammation and US findings for patients with knee OA. Meth-ods: For 50 consecutive subjects with symptomatic bilateral knee OA staged according to the scale Kellgren-Laurence(K-L) noted anamnestic data, Body Mass Index (BMI), func-tionality evaluated by Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and pain’ intensity through Visual Analogue Scale (VAS). Using the US, the cartilage, meniscal and tendon changes, osteophytes, and fluid collections were assessed for 100 knee joints. SPSS 29.0.2.0 was used for statistical analysis. Results: In our group, with an average age of 60.54 years, there was observed a weak direct correlation between WOMAC and K-L grading (r=0.34) and a negative correlation between BMI and the carti-lage size on the external femoral condyle (r=-0.28). Its thickness on this site was directly correlated with lateral osteophyte severity. Smokers' injuries on the intercondylar groove were increased. Conclusion: Lateral femoral condyle cartilage thickness is inversely asso-ciated with BMI, and K-L grading directly correlates with dysfunctionality. The smokers had higher intercondylar cartilage injuries. Keywords: Knee, osteoarthritis, pain, cartilage, ultrasonography.

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Inter and intra-examiner reliability of musculoskeletal ultrasound scanning of Anterior Talofibular Ligament and ankle muscles

Cited by 3 publications

References 38 publications

Anterior talofibular ligament's superior fascicle as a cause of ankle microinstability can be routinely identified by ultrasound

Anterior talofibular ligament's superior fascicle as a cause of ankle microinstability can be routinely identified by ultrasound

Anatomical study of the bone morphology of the anterior talofibular ligament attachment

Correlations Between Imaging and Clinical, Functional and Biological Features in Knee Osteoarthritis

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