Sonographic visibility of the main posterior ankle ligaments and para-ligamentous structures in 15 healthy subjects

Stella, Salvatore Massimo; Ciampi, Barbara; Chiaro, Andrea; Vallone, Gianfranco; Miccoli, Mario; Gulisano, Massimo; Orsitto, E; Galletti, Stefano

doi:10.1007/s40477-019-00420-2

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…Os trigonum is located at a distance from the Achilles tendon; therefore, a 9-12 MHz linear array transducer is recommended ( Fig. 9 ) [ 87 ].…”

Section: Os Trigonum Syndromementioning

confidence: 99%

Foot pain in children and adolescents: a problem-based approach in musculoskeletal ultrasonography

Liu,

Wang,

2024

Ultrasonography

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Various etiologies and risk factors contribute to foot pain in children and adolescents, including conditions such as Kohler's disease, Sever's disease, Iselin's disease, rigid flat foot, accessory navicular, Freiberg's disease, sesamoiditis, os trigonum syndrome, and more. High-frequency musculoskeletal ultrasonography can show both the bone surface and the surrounding soft tissue clearly from various angles in real-time, thereby providing a higher level of detail that is helpful for identifying the etiology of foot pain and monitoring disease progression compared with other imaging modalities. This review provides an overview of the epidemiology, pathophysiology, clinical manifestations and characteristic ultrasonographic findings of select foot pain conditions in children and adolescents.

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“…Os trigonum is located at a distance from the Achilles tendon; therefore, a 9-12 MHz linear array transducer is recommended ( Fig. 9 ) [ 87 ].…”

Section: Os Trigonum Syndromementioning

confidence: 99%

Foot pain in children and adolescents: a problem-based approach in musculoskeletal ultrasonography

Liu,

Wang,

2024

Ultrasonography

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“…While scrutinizing the PITFL, attention should be paid to its thickness, fibrillar pattern, discontinuity, presence of periligamentous fluid, presence and extent of any tears, and evidence of avulsion fractures of the tibia or lateral malleolus. In a cross-sectional study of 15 healthy ankles, the PITFL was easily identifiable and appeared flat and hyperechoic with a mean thickness of 1.2 mm (range, 1.0 to 1.6 mm) (30). The diagnostic accuracy of ultrasound in detecting PITFL partial and full-thickness tears has not yet been reported.…”

Section: Posterior Inferior Tibiofibular Ligamentmentioning

confidence: 99%

The Role of Ultrasound in the Management of Ankle Sprains and a Clinically Relevant Geisinger Ankle Sprain Sports Ultrasound Protocol

Meyer,

Loncar,

Jensen

et al. 2023

Curr Sports Med Rep

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Ankle sprains are the most common lower extremity injury in physically active individuals. These injuries are classified as lateral, medial, and/or syndesmotic. Treatment may include functional rehabilitation, bracing, weight-bearing restriction, medications, injections, and surgery. While most sprains heal rapidly, permanent disability and pain may arise. Diagnostic ultrasound has been demonstrated to be accurate in diagnosing ligamentous injuries, but it is often excluded from management algorithms that rely on physical examination alone to diagnose significant injuries. This article proposes a comprehensive, evidence-based diagnostic ankle ultrasound protocol to implement in conjunction with thorough history and physical examination. We also review the current literature to describe where this protocol most improves diagnostic accuracy compared with physical examination alone.

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“…13,14 To date, very few studies have been published regarding its use for syndesmotic injuries, with heterogenous results, 13,15,16 and these have solely been done in adults. 14,[17][18][19] The aims of this study were to determine if assessing anterior-inferior tibiofibular ligament (AiTFL) integrity using US was comparable with MRI in a pediatric population and to explore the possibility of establishing TFCS threshold values as a diagnostic tool for ligamentous integrity. Our hypotheses were that US would demonstrate a good to excellent sensitivity and specificity and that it would be possible to determine measurement thresholds of TFCS measures to diagnose or exclude syndesmotic injuries.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 To date, very few studies have been published regarding its use for syndesmotic injuries, with heterogenous results, 13,15,16 and these have solely been done in adults. 14,17–19…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Assessment of Ankle Syndesmotic Injuries in a Pediatric Population

Heitz,

Miron,

Beauséjour

et al. 2023

Clinical Journal of Sport Medicine

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Objective: To determine sensitivity and specificity for anterior-inferior tibiofibular ligament (AiTFL) integrity and tibiofibular clear-space (TFCS) cut-off points for dynamic evaluation using ultrasound (US) in a pediatric population. Design: Prospective cohort study. Setting: Tertiary care university-affiliated pediatric hospital patients between the ages of 12 and 18 sustaining acute ankle trauma with syndesmotic injury. Interventions: Participants were assigned to the syndesmotic injury protocol that included a standardized MRI and US. Main Outcome Measures: Anterior-inferior tibiofibular ligament integrity for static assessment and TFCS measurements for dynamic assessment on US. For dynamic assessment, the distance between the distal tibia and fibula was first measured in neutral position and then in external rotation for each ankle. The US results on AiTFL integrity were compared with MRI, considered as our gold standard. Optimal cut-off points of TFCS values were determined with receiver operating characteristics curve analysis. Results: Twenty-six participants were included. Mean age was 14.8 years (SD = 1.3 years). Sensitivity and specificity for AiTFL integrity were 79% and 100%, respectively (4 false negatives on partial tears). For dynamic assessment, the cut-off points for the differences in tibiofibular distance between the 2 ankles in 1) neutral position (TFCS N I-U) and 2) external rotation (TFCS ER I-U) were 0.2 mm (sensitivity = 83% and specificity = 80%) and 0.1 mm (sensitivity = 83% and specificity = 80%), respectively. Conclusions: Static US could be used in a triage context as a diagnostic tool for AiTFL integrity in a pediatric population as it shows good sensitivity and excellent specificity.

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Sonographic visibility of the main posterior ankle ligaments and para-ligamentous structures in 15 healthy subjects

Cited by 7 publications

References 16 publications

Foot pain in children and adolescents: a problem-based approach in musculoskeletal ultrasonography

Foot pain in children and adolescents: a problem-based approach in musculoskeletal ultrasonography

The Role of Ultrasound in the Management of Ankle Sprains and a Clinically Relevant Geisinger Ankle Sprain Sports Ultrasound Protocol

Ultrasound Assessment of Ankle Syndesmotic Injuries in a Pediatric Population

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