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Comparative Study
. 2014 Jan;87(1033):20130406.
doi: 10.1259/bjr.20130406.

Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings

Y Cheng  1 , Y Cai, Y Wang
Affiliations
Comparative Study

Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings

Y Cheng et al. Br J Radiol. 2014 Jan.

Abstract

Objective: The aim of this study was to assess the accuracy of ultrasonography in the diagnosis of chronic lateral ankle ligament injury.

Methods: A total of 120 ankles in 120 patients with a clinical suspicion of chronic ankle ligament injury were examined by ultrasonography by using a 5- to 17-MHz linear array transducer before surgery. The results of ultrasonography were compared with the operative findings.

Results: There were 18 sprains and 24 partial and 52 complete tears of the anterior talofibular ligament (ATFL); 26 sprains, 27 partial and 12 complete tears of the calcaneofibular ligament (CFL); and 1 complete tear of the posterior talofibular ligament (PTFL) at arthroscopy and operation. Compared with operative findings, the sensitivity, specificity and accuracy of ultrasonography were 98.9%, 96.2% and 84.2%, respectively, for injury of the ATFL and 93.8%, 90.9% and 83.3%, respectively, for injury of the CFL. The PTFL tear was identified by ultrasonography. The accuracy of identification between acute-on-chronic and subacute-chronic patients did not differ. The accuracies of diagnosing three grades of ATFL injuries were almost the same as those of diagnosing CFL injuries.

Conclusion: Ultrasonography provides useful information for the evaluation of patients presenting with chronic pain after ankle sprain.

Advances in knowledge: Intraoperative findings are the reference standard. We demonstrated that ultrasonography was highly sensitive and specific in detecting chronic lateral ligments injury of the ankle joint.

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Figures

Figure 1.
Figure 1.
Ultrasonographic view of a normal anterior talofibular ligament (arrows) about 1.9 mm thick (calipers). F, fibula; T, talus.
Figure 2.
Figure 2.
Sonogram shows a swollen anterior talofibular ligament (arrows). F, fibula; T, talus.
Figure 3.
Figure 3.
Transverse sonogram shows a partial tear (arrow) of the anterior talofibular ligament. The ligament is about 2.9 mm thick (calipers). A small amount of fluid (asterisk) in the ankle joint underlines the deep aspect of the ligament. F, fibula; T, talus.
Figure 4.
Figure 4.
Sonogram shows a partial tear (arrowhead) of the calcaneofibular ligament (arrows) near the attachment of the calcaneus. C, calcaneus; F, fibula; PT, peroneal tendons.
Figure 5.
Figure 5.
Sonogram shows a complete tear (arrowhead) of the anterior talofibular ligament (arrow). F, fibula; T, talus.
Figure 6.
Figure 6.
The anterior talofibular ligament fibre has been absorbed after tearing. Sonogram shows scar tissue (arrow) instead of the ligament fibre. F, fibula; T, talus.
Figure 7.
Figure 7.
A complete tear of the calcaneofibular ligament at the attachment of the calcaneus. Scar tissue (arrows) is seen instead of normal ligament fibre. C, calcaneus, PT, peroneal tendons.
See this image and copyright information in PMC

References

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