Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis

Abstract

Background: The studies about injury to the anterior talo-fibular ligament (ATFL) are focused mainly on chronic symptoms and chronic instability, and the literature about the accuracy of magnetic resonance imaging (MRI) in acute injuries is quite lacking. Methods: This systematic review with meta-analysis analyzes the diagnostic accuracy of MRI on acute ATFL injury. Relative studies were retrieved after searching three databases (MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. The quality of the included articles was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data were extracted to calculate pooled sensitivity and specificity of MRI. Results: Seven studies met our inclusion and exclusion criteria. For MRI, the pooled sensitivities and specificity in diagnosing acute ATFL injury were respectively 1.0 (95% CI: 0.58–1) and 0.9 (95% CI: 0.79–0.96). Pooled LR+ and LR− were respectively 10.4 (95% CI: 4.6–23) and 0 (95% CI: 0–0.82). Conclusion: This systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of acute ATFL injury. Our results demonstrated that MRI shows high diagnostic accuracy in the diagnosis of acute ATFL lesions. These results suggest that routine MRI in the case of suspected ATFL acute injury may be clinically useful, although this is not done in clinical practice due probably to high cost.

Avulsion fracture is associated with more pain after anatomic repair procedure for ATFL injury at the talar side

“…Injuries of the ATFL are mostly located on its fibular side, while talar side injuries are uncommon [4,12,14,30], with a low incidence of 6-9% on MRI and ultrasound in ankle sprain patients [6,7,18]. In the present study, 50 of 1353 patients (3.7%) with CAI were confirmed intraoperatively with an injury at the talar side of ATFL (Fig.…”

The Role of Mri in the Diagnosis of Ankle Ligaments Injury

“…Calceneofibular ligaments injury might be happened in main inversion strain, although it related with an anterior talofibular ligaments injury. On other hand, posterior talofibular ligaments are infrequently tom apart from case of entirely ankle dislocation [20]. Study by Helms et al, showed the ATFL is frequently torn ligaments in ankle joint.…”

Computer-Aided Ankle Ligament Injury Diagnosis from Magnetic Resonance Images Using Machine Learning Techniques

“…Subsequently, the medical analysis strategy used in this study is elaborated. As the most recent studies analyzed between 100 and 600 patients, and most of them classified the ligament in a more simplified fashion as normal ligament or altered ligament [ 14 , 17 ], this study made the difference between a normal, abnormal, and absent ligament, and so a larger sample was chosen.…”

“…Magnetic resonance imaging (MRI) provides optimal visualization of morphological changes in ankle ligament structures [ 5 , 6 , 7 , 8 ], however, the present set of literature lacks an accurate definition of a normal ATFL morphology [ 9 , 10 , 11 , 12 ]. Moreover, low accuracy is also observed in many studies [ 12 , 13 , 14 ] which could be due to the fact that it is a static exam used to study a structure that performs dynamic joint control. Further, it can potentially produce false negatives for ligament lesions, which would occur if the ligament was subjected to a yo-yo effect [ 11 , 13 , 15 , 16 , 17 , 18 ].…”