Ultrasonography of capsular morphology in normal and traumatic ankle joints

Friedrich, J. M.; Schnarkowski, P; Rübenacker, S.; Wallner, Bernd

doi:10.1002/jcu.1870210306

Cited by 44 publications

(22 citation statements)

References 8 publications

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“…28 Nazarian et al disclosed fluid in the anterior recess of the ankle joint in 33% of subjects examined. 29 In addition to our findings and those of two other studies, 28 30 Nazarian could not detect fluid in the posterior recess. In contrast, their study found retrocalcaneal bursal fluid in 50% of subjects, compared with 24% in our findings.…”

Section: Discussionsupporting

confidence: 78%

Standard reference values for musculoskeletal ultrasonography

Schmidt¹

2004

Annals of the Rheumatic Diseases

259

195

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Objectives: To determine standard reference values for musculoskeletal ultrasonography in healthy adults. Methods: Ultrasonography was performed on 204 shoulders, elbows, hands, hips, knees, and feet of 102 healthy volunteers (mean age 38.4 years; range 20-60; 54 women) with a linear probe (10-5 MHz; Esaote Technos MP). Diameters of tendons, bursae, cartilage, erosions, hypoechoic rims around tendons and at joints were measured with regard to established standard scans. Mean, minimum, and maximum values, as well as two standard deviations (2 SD) were determined. Mean values ¡2 SD were defined as standard reference values. Results: Hypoechoic rims were normally present in joints and tendon sheaths owing to physiological synovial fluid and/or cartilage. Similarly, fluid was found in the subdeltoid bursa in 173/204 (85%), at the long biceps tendon in 56 (27%), in the suprapatellar recess in 158 (77%), in the popliteal bursae in 32 (16%), and in the retrocalcaneal bursa in 49 (24%). Erosions of .1 mm were seen at the humeral head in 47 (23%). Values for important intervals were determined. The correlation between two investigators was 0.96 (0.78-0.99). The reliability of follow up investigations was 0.83 (0.52-0.99). Conclusions: Fluid in bursae as well as hypoechoic rims within joints and around tendons are common findings in healthy people. This study defines standard reference values for musculoskeletal ultrasonography to prevent misinterpretation of normal fluid as an anatomical abnormality.

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Section: Discussionsupporting

confidence: 78%

Standard reference values for musculoskeletal ultrasonography

Schmidt¹

2004

Annals of the Rheumatic Diseases

259

195

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“…A few studies have tried to characterize synovial fluid volume and distribution in normal as well as pathologic ankle joints that can be visualized with ultrasonography and magnetic resonance imaging 1245. Through the use of ultrasound, Schmidt et al characterized the physiologic normal volumes of the human ankle joint without any fluid being introduced into the joint 4.…”

Section: Discussionmentioning

confidence: 99%

“…Several radiographic studies have attempted to characterize the volume of synovial fluid in both normal and pathologic ankle joints through magnetic resonance imaging and ultrasonography 1–5. However, these studies have generally commented on relative sizes between normal and pathologic ankle joints and have not characterized the actual volume or pressures inside the joints.…”

Section: Introductionmentioning

confidence: 99%

Quantifying normal ankle joint volume: An anatomic study

Draeger¹,

Singh²,

Parekh³

2009

Indian J Orthop

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Background:Many therapeutic and diagnostic modalities such as intraarticular injections, arthrography and ankle arthroscopy require introduction of fluid into the ankle joint. Little data are currently available in the literature regarding the maximal volume of normal, nonpathologic, human ankle joints. The purpose of this study was to measure the volume of normal human ankle joints.Materials and Methods:A fluoroscopic guided needle was passed into nine cadaveric adult ankle joints. The needle was connected to an intracompartmental pressure measurement device. A radiopaque dye was introduced into the joint in 2 mL boluses, while pressure measurements were recorded. Fluid was injected into the joint until three consecutive pressure measurements were similar, signifying a maximal joint volume.Results:The mean maximum ankle joint volume was 20.9 ± 4.9 mL (range, 16–30 mL). The mean ankle joint pressure at maximum volume was 142.2 ± 13.8 mm Hg (range, 122–166 mm Hg). Two of the nine samples showed evidence of fluid tracking into the synovial sheath of the flexor hallucis longus tendon.Conclusion:Maximal normal ankle joint volume was found to vary between 16–30 mL. This study ascertains the communication between the ankle joint and the flexor hallucis longus tendon sheath. Exceeding maximal ankle joint volume suggested by this study during therapeutic injections, arthrography, or arthroscopy could potentially damage the joint.

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“…Compared with MRI, diagnostic ultrasound is useful but less accurate and sensitive in detecting acute lateral ankle ligamentous injury. 13,16,17 Evidence Category: B 12. Arthrography and tenography are less accurate than MRI and CT, especially when performed 48 hours after lateral ligamentous injury.…”

Section: Diagnosismentioning

confidence: 99%

“…For ultrasound versus MRI, accuracy was 95% and 100%, and sensitivity was 50% and 100%, respectively. Other authors 16,17 who compared ultrasonography for acute ankle injuries with surgical findings have shown accuracy ranging from 90% to 100% for both the ATFL and CFL.…”

mentioning

confidence: 99%

National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

Kaminski

Hertel

Amendola

et al. 2013

Journal of Athletic Training

207

233

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Objective: To present recommendations for athletic trainers and other allied health care professionals in the conservative management and prevention of ankle sprains in athletes.Background: Because ankle sprains are a common and often disabling injury in athletes, athletic trainers and other sports health care professionals must be able to implement the most current and evidence-supported treatment strategies to ensure safe and rapid return to play. Equally important is initiating preventive measures to mitigate both first-time sprains and the chance of reinjury. Therefore, considerations for appropriate preventive measures (including taping and bracing), initial assessment, both short-and long-term management strategies, return-to-play guidelines, and recommendations for syndesmotic ankle sprains and chronic ankle instability are presented.Recommendations: The recommendations included in this position statement are intended to provide athletic trainers and other sports health care professionals with guidelines and criteria to deliver the best health care possible for the prevention and management of ankle sprains. An endorsement as to best practice is made whenever evidence supporting the recommendation is available.

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Ultrasonography of capsular morphology in normal and traumatic ankle joints

Cited by 44 publications

References 8 publications

Standard reference values for musculoskeletal ultrasonography

Standard reference values for musculoskeletal ultrasonography

Quantifying normal ankle joint volume: An anatomic study

National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

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