| 5. Berman Z, Tafur M, Ahmed SS, Huang BK, Chang EY. Ankle impingement syndromes: an imaging review. [Review]. Br J Radiol. 90(1070):20160735, 2017 Feb. |
Review/Other-Dx |
N/A |
To review the relevant anatomy of the different compartments, describe the mechanisms of injury with common imaging findings, differential diagnoses when applicable and to review the different treatments options for ankle impingement syndromes. |
No results stated in abstract. |
4 |
| 6. Barbier O. Osteochondral lesions of the talar dome. [Review]. Orthopaedics & traumatology, surgery & research. 109(1S):103452, 2023 02.Orthop Traumatol Surg Res. 109(1S):103452, 2023 02. |
Review/Other-Dx |
N/A |
To review the issue of osteochondral lesion of the talar dome (OLTD) |
No results stated in abstract. |
4 |
| 7. Ellsworth BK, Kehoe C, DeFrancesco CJ, Bogner E, Mintz DN, Scher DM. Talocalcaneal Tarsal Coalition Size: Evaluation and Reproducibility of MRI Measurements. J Pediatr Orthop. 2022 Jul 01;42(6):e612-e615. |
Review/Other-Dx |
27 patients |
To create a method to reproducibly measure TCC size using MRI. |
The ICC scores for all but one of the MRI measurements indicated good to excellent inter-rater reliability among the 5 examiners. The ICC was 0.932 (95% confidence interval: 0.881-0.966) for measurement of total coalition width/total healthy posterior facet width and 0.948 (95% confidence interval: 0.908-0.973) for measurement of total coalition width/total subtalar facet width (middle+posterior+coalition). |
4 |
| 9. Guillodo Y, Varache S, Saraux A. Value of ultrasonography for detecting ligament damage in athletes with chronic ankle instability compared to computed arthrotomography. Foot Ankle Spec. 2010 Dec;3(6):331-4. |
Observational-Dx |
56 patients |
To assess the performance of ultrasonography in assessing damage to the anterior talofibular ligament (ATFL) in athletes with chronic ankle instability after a sprain. |
ATFL damage was found by US in 34 (61%) of 56 patients and by CT in 39 of 55 patients (71%; kappa = 0.76). Cartilage damage was visualized by computed arthrotomography in 14 (25%) patients, all of whom had ATFL damage. Agreement was substantial (kappa = 0.76) between ultrasonography and computed arthrotomography for assessing the ATFL. The data support the use of ultra-sonography as the second-line investigation after a standard radiographic assessment in athletes with chronic ankle instability after a sprain. |
3 |
| 17. Kloprogge SES, Lachmipersad RMMR, Katier NN, et al. Prognostic factors and the value of radiographic osteoarthritis for persistent complaints after referral for ankle radiography. Semin Arthritis Rheum. 2024 Oct;68():S0049-0172(24)00127-6. |
Review/Other-Dx |
893 patients |
Ankle symptoms are a common reason to consult the general practitioner and often persist for years. |
Of the 194 responders at follow-up, ankle complaints persisted in 71(36.6 %). BMI (OR 1.08; 95 % CI 1.01-1.15), stiffness as predominant symptom (OR 1.69; 95 % CI 0.89-3.21), and chronic complaints (OR 2.84; 95 % CI 1.45-5.57) were in the initial model for persistent complaints (AUC=0.69). After adding radiographic OA (OR 2.36; 95 % CI 1.01-5.50), the AUC of the final model became 0.70. |
4 |
| 18. Dowling LB, Giakoumis M, Ryan JD. Narrowing the normal range for lateral ankle ligament stability with stress radiography. J Foot Ankle Surg. 53(3):269-73, 2014 May-Jun. |
Experimental-Dx |
50 patients |
To narrow the threshold for the diagnosis of ankle ligament injury using stress radiographs by refining the values seen in the normal ankle. |
Bilateral radiographic images of anterior drawer and talar tilt stress tests were taken of 50 participants (100 ankles) with no history of ankle fracture or surgical intervention for ankle instability. Participants with a previous ankle sprain were later excluded from the result computations. Factors such as patient age and gender were evaluated. In the final analysis, 46 participants (76 ankles) were included, with a mean anterior drawer test result of 2.00 mm ± 1.71 mm and talar tilt test result of 3.39° ± 2.70° in the normal ankle. |
3 |
| 19. Haug LP, Sill AP, Shrestha R, Patel KA, Kile TA, Fox MG. Osteochondral Lesions of the Ankle and Foot. Semin Musculoskelet Radiol. 2023 Jun;27(3):269-282. |
Review/Other-Dx |
N/A |
To discuss radiographs, ultrasonography, computed tomography, single-photon emission computed tomography/computed tomography, and magnetic resonance imaging to evaluate OCLs. |
No results stated in abstract. |
4 |
| 23. Bureau NJ, Cardinal E, Hobden R, Aubin B. Posterior ankle impingement syndrome: MR imaging findings in seven patients. Radiology. 2000 May;215(2):497-503. |
Review/Other-Dx |
7 patients |
MRI findings in patients with posterior ankle impingement (PAI) syndrome are reported. |
MRI clearly depicts the osseous and soft-tissue abnormalities associated with PAI syndrome and is useful in the assessment of this condition. |
4 |
| 24. Robinson P, White LM, Salonen DC, Daniels TR, Ogilvie-Harris D. Anterolateral ankle impingement: mr arthrographic assessment of the anterolateral recess. Radiology. 2001 Oct;221(1):186-90. |
Observational-Dx |
32 patients |
Prospective study to determine the accuracy of MR arthrography in assessing the anterolateral recess of the ankle. |
MR arthrographic assessment of the anterolateral soft tissues had an accuracy of 97%, sensitivity of 96%, specificity of 100%, NPV of 89%, and PPV of 100%. Accuracy was 100% with clinical ALI, with an arthroscopically confirmed abnormality in 12 cases and a normal appearance in one. Anterolateral soft-tissue thickening was identified at MR arthrography in 11 control cases, with arthroscopic confirmation in all. The remaining cases had normal appearances, with an arthroscopic soft-tissue abnormality in one case and a normal appearance in seven. MR arthrography of the tibiotalar joint is accurate in assessing the anterolateral recess of the ankle. |
2 |
| 30. Aboelmagd SM, Low SB, Cahir JG, et al. The Norwich Osteoarthritis of the Ankle MRI Score (NOAMS): a reliability study. Clin Radiol. 2022 Jun;77(6):S0009-9260(22)00117-9. |
Observational-Dx |
50 |
To define and test the inter- and intra-rater reliability of a grading system for staging osteoarthritis (OA) of the ankle with magnetic resonance imaging (MRI) (Norwich Osteoarthritis of the Ankle MRI Score, NOAMS). |
he inter-rater kappa coefficient of agreement for cartilage disease was 0.88 (95% confidence interval [CI]: 0.85, 0.91) for experienced raters and 0.71 (95% CI: 0.67, 0.76) for trainees. Inter-rater agreement for subchondral bone marrow oedema and cysts varied from 0.73 to 0.82 for experienced raters and from 0.63 to 0.75 for trainees with lowest 95% CI of 0.48 and 0.63. When bone marrow lesions were combined into a total joint score the level of agreement increased to between 0.88 and 0.97 with lowest 95% CI of 0.86. Combining cartilage zone scores did not increase the reliability coefficients. |
3 |
| 31. Duncan D, Mologne T, Hildebrand H, Stanley M, Schreckengaust R, Sitler D. The usefulness of magnetic resonance imaging in the diagnosis of anterolateral impingement of the ankle. J Foot Ankle Surg. 2006;45(5):304-307. |
Observational-Dx |
24 patents; 12 had arthroscopically documented anterolateral impingement and 12 controls |
To assess the sensitivity and specificity of MRI in the diagnosis of anterolateral impingement of the ankle and to assess the most helpful sequence in making the diagnosis. |
Sensitivities varied from 0.75 to 0.83, whereas specificities varied from 0.75 to 1.00. Using the Fisher exact test of contingency, the sensitivities and specificities showed that all reviewers' interpretations were statistically significant with P = .039, .001, and .012, respectively. The axial images were felt to be most helpful in making the diagnosis. The physicians felt that the sagittal images were helpful in 67%, 83%, and 100%, respectively. MRI is a useful tool that can aid the clinician in the diagnosis of anterolateral impingement of the ankle. T1 sagittal images demonstrating displacement of the normal fat signal anterior to the fibula by scar can be useful and help to confirm the diagnosis. |
3 |
| 32. Donovan A, Rosenberg ZS. MRI of ankle and lateral hindfoot impingement syndromes. [Review] [74 refs]. AJR Am J Roentgenol. 195(3):595-604, 2010 Sep. |
Review/Other-Dx |
N/A |
To review the pathophysiology and clinical presentation of impingement syndromes at the ankle joint (anterolateral, anterior, anteromedial, posteromedial, and posterior) and the role of MRI in evaluating impingement at the ankle joint and at extraarticular locations, lateral to the ankle joint (talocalcaneal and calcaneofibular). |
MRI is valuable in assessing both osseous and soft-tissue abnormalities associated with impingement syndromes. |
4 |
| 33. Russo A, Zappia M, Reginelli A, et al. Ankle impingement: a review of multimodality imaging approach. Musculoskelet Surg. 2013 Aug;97 Suppl 2():S161-8. |
Review/Other-Dx |
N/A |
To describe the clinical and potential imaging features, for the four main impingement syndromes of the ankle: anterolateral, anterior, anteromedial, posterior, and posteromedial impingement. |
No results stated in abstract. |
4 |
| 34. Hayashi D, Roemer FW, D'Hooghe P, Guermazi A. Posterior ankle impingement in athletes: Pathogenesis, imaging features and differential diagnoses. Eur J Radiol. 2015 Nov;84(11):S0720-048X(15)30058-9. |
Review/Other-Dx |
N/A |
To describe different types of posterior ankle impingement due to traumatic and non-traumatic osseous and soft tissue pathology in athletes, to describe diagnostic imaging strategies of these pathologies, and illustrate their imaging features, including relevant differential diagnoses. |
No results stated in abstract. |
4 |
| 35. Berberian WS, Hecht PJ, Wapner KL, DiVerniero R. Morphology of tibiotalar osteophytes in anterior ankle impingement. Foot Ankle Int. 2001 Apr;22(4):313-7. |
Review/Other-Dx |
9 patients |
To document radiographic trends in the size and location of osteophytes occurring in patients who have undergone surgical treatment of bony anterior ankle impingement. |
Osteophyte size was measured on plain lateral radiographs, and axial CT images were used to determine both tibial and talar osteophyte location by referencing them to the midline of the talar dome. 95% confidence intervals demonstrated that the talar spur peak lies medial to the midline, the tibial spur peak lies lateral to the midline, and the spurs typically do not overlap each other. Further, the tibial spur is wider than the talar spur, and the talar spur usually protrudes medially off the medial edge of the talar neck. |
4 |
| 36. de Carvalho KAM, Barbachan Mansur NS, de Cesar Netto C. Cone-Beam Weight-Bearing Computed Tomography of Ankle Arthritis and Total Ankle Arthroplasty. Foot Ankle Clin. 2023 Sep;28(3):S1083-7515(23)00060-8. |
Review/Other-Dx |
N/A |
Weight-bearing computed tomography has multiple advantages in evaluating the hindfoot and ankle. |
No results stated in abstract. |
4 |
| 37. Arena CB, Sripanich Y, Leake R, Saltzman CL, Barg A. Assessment of Hindfoot Alignment Comparing Weightbearing Radiography to Weightbearing Computed Tomography. Foot Ankle Int. 2021 Nov;42(11):1482-1490. |
Review/Other-Dx |
375 patients |
To compare the 2D calcaneal moment arm measurements on HAV radiographs with WBCT. |
The intraclass correlation coefficients (ICCs) of interobserver and intraobserver reliability for measurements with both imaging modalities were excellent. Both modalities were highly correlated (Spearman coefficient, 0.930; P < .001). HAV radiographs exhibited a mean calcaneal moment arm difference of 3.9 mm in the varus direction compared with WBCT (95% CI, -4.9 to 12.8). The difference of hindfoot alignment between both modalities was comparable in subgroups with neutral/valgus/varus alignment, presence of hardware, and motion artifact. |
4 |
| 38. Cochet H, Pele E, Amoretti N, Brunot S, Lafenetre O, Hauger O. Anterolateral ankle impingement: diagnostic performance of MDCT arthrography and sonography. AJR Am J Roentgenol. 194(6):1575-80, 2010 Jun. |
Observational-Dx |
51 consecutive patients |
Prospective study to compare the diagnostic performance of CT arthrography and sonography in the diagnosis of anterolateral ankle impingement. |
The sensitivity and specificity of sonography were respectively 77% and 57% before joint injection and 85% and 71% after joint injection. Positive Doppler masses were found to be anterolateral impingements at arthroscopy in all cases (10/10), and masses of hyperechoic appearance were found not to be anterolateral impingements in all cases (3/3). The sensitivity and specificity of CT arthrography in the diagnosis of anterolateral impingement were respectively 97% and 71%. The performances of CT arthrography and ankle sonography in the diagnosis of anterolateral ankle impingement were significantly different (p = 0.006). CT arthrography is quite accurate and superior to ankle sonography in the diagnosis of anterolateral impingement. The diagnostic performance of sonography is limited, but positive Doppler appearance and hyperechogenicity, when present, could help to exclude or confirm the diagnosis. |
2 |
| 39. McCarthy CL, Wilson DJ, Coltman TP. Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging. Skeletal Radiol. 37(3):209-16, 2008 Mar. |
Observational-Dx |
17 footballers ; clinical diagnosis of ALI (n = 8) or control condition (n = 9) |
To evaluate the findings and diagnostic accuracy of US in ALI. US findings were correlated with subsequent arthroscopic appearance. |
US detected a synovitic mass in the antero-lateral gutter in all 8 footballers with clinical ALI (100%) and in 2 patients with a control diagnosis (22%). US is accurate in detecting synovitic lesions within the antero-lateral gutter, demonstrating associated ligamentous injuries and in differentiating soft tissue from osseous impingement. |
3 |
| 40. Cerezal L, Llopis E, Canga A, Rolón A. MR arthrography of the ankle: indications and technique. Radiol Clin North Am. 2008 Nov;46(6):973-94, v. |
Review/Other-Dx |
N/A |
MR arthrography has become an important tool for the assessment of a variety of ankle disorders. |
No results stated in abstract. |
4 |
| 41. Huh YM, Suh JS, Lee JW, Song HT. Synovitis and soft tissue impingement of the ankle: assessment with enhanced three-dimensional FSPGR MR imaging. J Magn Reson Imaging. 2004;19(1):108-116. |
Observational-Dx |
20 patients. |
To assess soft tissue impingement as well as synovitis of the ankle associated with trauma by using contrast-enhanced (CE), fat-suppressed, three-dimensional, fast gradient-recalled acquisition in the steady state with radiofrequency spoiling (FSPGR) magnetic resonance (MR) imaging. |
For the assessment of synovitis, fat-suppressed CE three-dimensional FSPGR MR imaging had an accuracy of 72.9%, sensitivity of 91.5%, and specificity of 63.9%; whereas for that of soft tissue impingement it had an accuracy of 94.4%, sensitivity of 76.5%, and specificity of 96.9%. All of the asymptomatic subjects showed grade I (81%) or II (19%) synovial enhancement. |
2 |
| 44. Verhagen RA, Maas M, Dijkgraaf MG, Tol JL, Krips R, van Dijk CN. Prospective study on diagnostic strategies in osteochondral lesions of the talus. Is MRI superior to helical CT? J Bone Joint Surg Br. 2005;87(1):41-46. |
Observational-Dx |
103 patients (104 ankles) |
Prospective study to determine the best diagnostic method for discriminating between patients with and without osteochondral lesions of the talus, with special relevance to the value of MRI compared with the new technique of multidetector helical CT. Authors compared the diagnostic value of history, physical examination and standard radiography, a 4 cm heel-rise view, helical CT, MRI, and diagnostic arthroscopy for simultaneous detection or exclusion of osteochondral lesions of the talus. |
Helical CT, MRI and diagnostic arthroscopy were significantly better than history, physical examination and standard radiography. MRI and diagnostic arthroscopy performed better than a mortise view with a 4 cm heel-rise. No statistically significant difference between helical CT and MRI. Diagnostic arthroscopy did not perform better than helical CT and MRI. |
2 |
| 45. Posadzy M, Desimpel J, Vanhoenacker F. Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. J Belg Soc Radiol. 2017 Dec 16;101(Suppl 2):1. |
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| 46. Lee KB, Bai LB, Park JG, Yoon TR. A comparison of arthroscopic and MRI findings in staging of osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc. 2008;16(11):1047-1051. |
Observational-Dx |
50 patients (52 cases) |
To evaluate the accuracy of MRI compared with arthroscopy in staging of osteochondral lesions of the talus (OLTs). The authors prospectively investigated 50 patients (52 cases) who had undergone both MRI and ankle arthroscopy for OLTs. |
A comparison of MRI and arthroscopic stagings revealed that MRI had an accuracy of 81% (42 of 52) for staging of OLTs. MRI correctly staged 3 of 7 stage I lesions, 5 of 11 stage II, 25 of 25 stage III, and 9 of 9 stage IV lesions. Ten mismatched cases were of arthroscopic stage III lesions, which MRI classified as four stage I lesions and six stage II lesions. Thus, MRI staging tended to understate lesion severity. The authors re-reviewed the ten MR images of the mismatching cases to identify reasons for these mismatches, and subchondral edema was found in six cases. MRI has accuracy of 81% in staging of OLTs, however, MRI had some limitation in correct staging isolated cartilage lesions of OLTs, especially combined with subchondral edema. |
3 |
| 47. Mintz DN, Tashjian GS, Connell DA, Deland JT, O'Malley M, Potter HG. Osteochondral lesions of the talus: a new magnetic resonance grading system with arthroscopic correlation. Arthroscopy. 2003 Apr;19(4):353-9. |
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| 48. Kirschke JS, Braun S, Baum T, et al. Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle. Biomed Res Int. 2016;2016():3594253. |
Review/Other-Dx |
79 patients |
To determine the diagnostic value of computed tomography arthrography (CTA) of the ankle in the evaluation of (osteo)chondral lesions in comparison to conventional magnetic resonance imaging (MRI) and intraoperative findings. |
On CTA, 41/79 and 31/79 patients had full thickness cartilage defects at the talus and at the tibia, respectively. MRI was able to detect 54% of these defects. For the detection of full thickness cartilage lesions, interobserver agreement was substantial (0.72 ± 0.05) for CTA and moderate (0.55 ± 0.07) for MRI. In surgical reports, 88-92% and 46-62% of full thickness defects detected by CTA and MRI were described. CTA findings changed the further clinical management in 15.4% of cases. |
4 |
| 49. Kim DY, Yoon JM, Park GY, Kang HW, Lee DO, Lee DY. Computed tomography arthrography versus magnetic resonance imaging for diagnosis of osteochondral lesions of the talus. Arch Orthop Trauma Surg. 2023 Sep;143(9):5631-5639. |
Review/Other-Dx |
35 patients |
To compare the diagnostic value of CT arthrography (CTa) with that of MRI using arthroscopy as the reference standard for grading OLT. |
CTa was statistically significantly better in detecting chondral flapping or subchondral exposure lesions for OLT than MRI on using arthroscopy as the reference standard. Because the stability of the OLT is essential in determining the treatment method, if an OLT is observed on MRI and is suspected to cause ankle pain, we recommend additional CTa examination to determine the more correct treatment strategies for OLT. |
4 |
| 50. Schmid MR, Pfirrmann CW, Hodler J, Vienne P, Zanetti M. Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography. Skeletal Radiol. 2003 May;32(5):259-65. |
Observational-Dx |
36 consecutive patients |
To compare MR arthrography and CT arthrography for the evaluation of cartilage lesions in the ankle joint. |
For reader 1 accuracy of MR arthrography in the talus/tibia/fibula (88%/88%/94%) was slightly inferior to CT arthrography (90%/94%/92%). For reader 2, the accuracy was 76%/78%/83% for MR arthrography, and 92%/93%/92% for CT arthrography, respectively. Interobserver agreement for MR arthrography was 79%/74%/89% (kappa 0.47/0.34/0.27), while interobserver agreement for CT arthrography was 89%/90%/89% (kappa 0.69/0.54/0.54). CT arthrography appears to be more reliable than MR arthrography for the detection of cartilage lesions in the ankle joint. |
2 |
| 51. Meftah M, Katchis SD, Scharf SC, Mintz DN, Klein DA, Weiner LS. SPECT/CT in the management of osteochondral lesions of the talus. Foot Ankle Int. 2011;32(3):233-238. |
Observational-Tx |
22 patients. |
To assess the value of single-photon emission comuted tomography (SPECT)/ comuted tomography (CT) in the management of osteochondral lesion of the talus (OLT). |
Twelve patients underwent ankle arthroscopy for debridement or drilling of the osteochondral lesion. The mean American Orthopaedic Foot and Ankle Society(AOFAS) score in these 12 patients was 83.6. SPECT/CT helped preoperative planning by identifying the exact location of the active lesion, especially in multifocal disease or revision surgeries while showing the depth of the active lesion. Ten patients had conservative management due to minimal or no activity over the lesion on SPECT/CT images. The mean AOFAS score in these ten patients was 78.8 which was comparable to the operative group. |
2 |
| 52. Marth AA, Feuerriegel GC, Marcus RP, Sutter R. How accurate is MRI for diagnosing tarsal coalitions? A retrospective diagnostic accuracy study. Eur Radiol. 2024 May;34(5):3493-3502. |
Review/Other-Dx |
56 patients |
To evaluate the diagnostic accuracy, inter-reader agreement, and associated pathologies on MR images of patients with confirmed TC. |
The majority of TCs were non-osseous (91.1%) and located at the calcaneonavicular (33.9%) or talocalcaneal joint (66.1%). Associated pathologies included adjacent and distant bone marrow edema (57.1% and 25.0%), osteochondral defect of the talar dome (OCD, 19.6%), and joint effusion (10.7%) and accessory anterolateral talar facet (17.9%). Talar OCD was associated with increased patient age (p = 0.03). MRI exhibited a cumulative sensitivity and specificity of 95.8% and 94.3% with almost perfect inter-reader agreement (? = 0.895). |
4 |
| 53. Mehdi N, Bernasconi A, Lintz F. Tarsal coalition in adults. [Review]. Orthopaedics & traumatology, surgery & research. 110(1S):103761, 2024 Feb.Orthop Traumatol Surg Res. 110(1S):103761, 2024 Feb. |
Review/Other-Dx |
N/A |
Adult tarsal coalition consists in abnormal union of two or more tarsal bones. |
No results stated in abstract. |
4 |
| 54. Emery KH, Bisset GS, Johnson ND, Nunan PJ. Tarsal coalition: a blinded comparison of MRI and CT. Pediatr Radiol. 1998 Aug;28(8):612-6. |
Observational-Dx |
20 patients |
To determine how well MRI can detect tarsal coalition compared with CT, the current imaging standard. |
Both modalities prospectively identified 15 coalitions (9 patients) and each missed 1 calcaneonavicular coalition. Twenty-three of the remaining 24 feet were negative for coalition on both CT and MRI. An atypical incomplete talocalcaneal coalition seen on CT was not identified prospectively on MRI. |
2 |
| 55. Catanzano AA, Akoh CC, Easley ME, Mosca VS. Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review. JBJS Rev. 2023 Jun 01;11(6). |
Review/Other-Dx |
N/A |
Tarsal coalitions most commonly affect the calcaneonavicular and talocalcaneal joints in up to 13% of the general population. |
No results stated in abstract. |
4 |
| 57. Oae K, Takao M, Uchio Y, Ochi M. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging. Skeletal Radiol. 2010;39(1):41-47. |
Observational-Dx |
34 patients |
To clarify the efficacy of stress radiography (stress X-P), US, and MRI in the detection of the anterior talofibular ligament (ATFL) injury. |
Arthroscopic findings showed ATFL injury in 30 out of 34 cases. The diagnosis of ATFL injury with stress X-P, US, MR imaging were made with an accuracy of 67, 91 and 97%. US and MR imaging demonstrated the same location of the injury as arthroscopy in 63 and 93%. |
3 |
| 58. Joshy S, Abdulkadir U, Chaganti S, Sullivan B, Hariharan K. Accuracy of MRI scan in the diagnosis of ligamentous and chondral pathology in the ankle. Foot Ankle Surg. 2010;16(2):78-80. |
Observational-Dx |
24 patients |
To determine the accuracy of MRI scan in relation to arthroscopic findings in patients presenting with chronic ankle pain and/or instability. Arthroscopic findings were considered as a gold standard. |
MRI showed 100% specificity for the diagnosis of anterior talofibular ligament (ATFL) and CFL tears and osteochondral lesions. However sensitivity was low particularly for calcaneofibular ligament (CFL) tears. Accuracy of MRI in detecting ATFL tear was 91.7%, CFL tear was 87.5% and osteochondral lesion was 83.3%. MRI scan has very high specificity and PPVin diagnosing tears of ATFL, CFL and osteochondral lesions. However sensitivity was low with MRI. In a symptomatic patient negative results on MRI must be viewed with caution and an arthroscopy may still be required for a definitive diagnosis and treatment. However high resolution scans may differ in their ability to pick up these lesions and further research is required to assess their efficiency as evidence is not currently available. |
3 |
| 59. Park HJ, Cha SD, Kim SS, et al. Accuracy of MRI findings in chronic lateral ankle ligament injury: comparison with surgical findings. Clin Radiol. 2012;67(4):313-318. |
Observational-Dx |
48 patients |
To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. |
The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. |
3 |
| 60. Crim J, Longenecker LG. MRI and surgical findings in deltoid ligament tears. AJR Am J Roentgenol. 204(1):W63-9, 2015 Jan. |
Observational-Dx |
88 cases |
To determine the accuracy of new MRI criteria in detecting tears of the superficial deltoid ligament of the ankle, the accuracy of established criteria for detecting deep deltoid ligament tears, the most common location of super-ficial deltoid ligament tears, and the frequency of other injuries associated with deltoid tears. |
MRI findings of focal detachment of the superficial deltoid origin or detachment of the fascial sleeve of the medial malleolus yielded a sensitivity for superficial deltoid ligament tears of 83.3% (45/54) and specificity of 93.9% (31/33). Eight of nine prospectively missed tears were visible on retrospective review. All superficial deltoid tears involved the origin of the ligament from the medial malleolus, and six involved mid or distal bundles of the superficial deltoid as well. MRI findings of discontinuity or nonvisualization of discrete fibers yielded a sensitivity for deep deltoid ligament tears of 96.3% (26/27) and specificity of 97.9% (46/47). |
3 |
| 61. Oae K, Takao M, Naito K, et al. Injury of the tibiofibular syndesmosis: value of MR imaging for diagnosis. Radiology. 2003 Apr;227(1):155-61. |
Observational-Dx |
58 patients |
To evaluate the use of MR imaging, as compared with the use of arthroscopy, for the diagnosis of tibiofibular syndesmotic injury. |
Arthroscopic findings showed anteroinferior tibiofibular ligament (AITFL) disruption in 28 patients and posteroinferior tibiofibular ligament (PITFL) disruption in five patients. When an MR imaging diagnosis was based on criterion 1 only, the diagnosis of AITFL disruption was made with a sensitivity of 100%, a specificity of 70%, and an accuracy of 84%, and the diagnosis of PITFL disruption was made with a sensitivity of 100%, a specificity of 94%, and an accuracy of 95%. When an MR imaging diagnosis was based on criteria 1 and 2, the diagnosis of AITFL disruption was made with a sensitivity of 100%, a specificity of 93%, and an accuracy of 97%, whereas the diagnosis of PITFL disruption was made with a sensitivity of 100%, a specificity of 100%, and an accuracy of 100%. MR imaging with use of both criteria is highly accurate for the diagnosis of tibiofibular syndesmotic disruption. |
3 |
| 62. Nielson JH, Sallis JG, Potter HG, Helfet DL, Lorich DG. Correlation of interosseous membrane tears to the level of the fibular fracture. J Orthop Trauma. 2004;18(2):68-74. |
Observational-Dx |
73 patients |
Prospective clinical trial to correlate interosseous membrane (IOM) tears of the ankle to the height of fibular fractures in operative ankle fractures. Open reduction and internal fixation of each ankle fracture was performed after preoperative MRI evaluation of the IOM. |
Of the 73 ankle fractures with adequate MRI evaluation, 30 had identifiable complete IOM tears on MRI. Ten of the 30 IOM tears did not correlate with the level of the fractured fibula. Seven cases had IOM tears proximal to the fibular fracture as detected by MRI. Five of these cases were Weber B type fractures, and two were Weber C type fracture patterns. Conversely, three cases of Weber C type fractures had IOM tears that remained distal to the level of the fibular fracture. The level of the fibular fracture does not correlate reliably with the integrity or extent of the interosseous membrane tears identified on MRI in operative ankle fractures. |
3 |
| 63. DiGiovanni BF, Fraga CJ, Cohen BE, Shereff MJ. Associated injuries found in chronic lateral ankle instability. Foot Ankle Int. 2000;21(10):809-815. |
Observational-Dx |
61 patients |
Retrospective review of clinical history, physical examination, MRI, and intraoperative findings to determine the type and frequency of associated injuries found at surgery and during the preoperative evaluation. |
The injuries found most often by direct inspection included: Peroneal tenosynovitis, 47/61 patients (77%); anterolateral impingement (ALI) lesion, 41/61 (67%); attenuated peroneal retinaculum, 33/61 (54%); and ankle synovitis, 30/61 (49%). Other less common but significant associated injuries included: intra-articular loose body, 16/61 (26%); peroneus brevis tear, 15/61 (25%); talus osteochondral lesion, 14/61 (23%); medial ankle tendon tenosynovitis, 3/61 (5%). Study findings indicate there is a high frequency of associated injuries in patients with chronic lateral ankle instability. Peroneal tendon and retinacular pathology, as well as anterolateral impingement lesions, occur most often. A high index of suspicion for possible associated injuries may result in more consistent outcomes with nonoperative and operative treatment of patients with chronic lateral ankle instability. |
4 |
| 64. Chien AJ, Jacobson JA, Jamadar DA, Brigido MK, Femino JE, Hayes CW. Imaging appearances of lateral ankle ligament reconstruction. Radiographics. 2004;24(4):999-1008. |
Review/Other-Dx |
6 patients |
To review lateral ankle ligament reconstruction and their imaging appearances at radiography (anteroposterior, lateral, oblique), US, and MRI. |
At radiography and MRI, the presence of one or more suture anchors in the region of the ATFL indicates direct ligament repair, whereas a fibular tunnel indicates peroneus brevis tendon rerouting or loop. US and MRI demonstrate rerouted tendons as part of lateral ankle reconstruction; however, MRI can also depict the rerouted tendon within an osseous tunnel if present (T1-weighted sequences are used). |
4 |
| 65. Elkaïm M, Thès A, Lopes R, et al. Agreement between arthroscopic and imaging study findings in chronic anterior talo-fibular ligament injuries. Orthop Traumatol Surg Res. 2018 Dec;104(8S):S1877-0568(18)30264-0. |
Observational-Dx |
286 patients |
To adapt an arthroscopic classification of chronic ATFL lesions to the pre-operative imaging study findings in order to estimate the performance of computed tomography (CT)-arthrography, ultrasonography, and magnetic resonance imaging (MRI) in diagnosing ATFL lesions, using arthroscopy as the reference standard. |
Of the 286 patients, 157 had complete information on the arthroscopic assessment and on pre-operative imaging studies and were included in the analysis. Imaging studies were CT-arthrography in 49 patients, ultrasonography in 63 patients, and MRI in 45 patients; both ultrasonography and MRI were performed in 3 patients. Agreement with arthroscopy was 82% and 88.5% for CT-arthrography, 66.7% and 76.2% for ultrasonography, 70.5% and 79.5% for MRI, and 73.4% and 81.2% for all imaging studies pooled. |
1 |
| 66. Christodoulou G, Korovessis P, Giarmenitis S, Dimopoulos P, Sdougos G. The use of sonography for evaluation of the integrity and healing process of the tibiofibular interosseous membrane in ankle fractures. J Orthop Trauma. 1995;9(2):98-106. |
Observational-Dx |
6 patients - experimental study; 90 consecutive patients - clinical study |
To evaluate the value of US in the diagnosis of the rupture and healing process of the IOM in Weber type B and C ankle fractures. |
All Weber type C fractures showed a rupture of the interosseous membrane, while only 23% of the Weber type B fractures were associated with a rupture of the interosseous membrane (p < 0.001). In the vast majority of the cases (77%), particularly in all Weber type B fractures (p < 0.01), the rupture of the interosseous membrane extended above the proximal fracture line of the fibula. By means of sonography, in the acute posttrauma period a rupture of the interosseous membrane was found in 37.4% of the cases. In this series, the results of sonography and the operative findings coincided in 88.6% of the cases concerning location, type, and extent. The sensitivity of the sonography in the diagnosis of the rupture of the interosseous membrane was 88.8%, the diagnostic value of the method 92.2%, and specificity 94.5%. The sonographic findings of the healing process of the interosseous membrane were in absolute (100%) agreement with the intraoperative observations at the time of removal of the osteosynthesis material. Complete healing occurred within 3-5 months after trauma in 70% of the cases of ruptured interosseous membrane. |
2 |
| 67. Cho JH, Lee DH, Song HK, Bang JY, Lee KT, Park YU. Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy. Knee Surg Sports Traumatol Arthrosc. 24(4):1022-8, 2016 Apr. |
Observational-Dx |
28 patients. |
To assess the diagnostic value of stress ultrasound for chronic ankle instability compared to the manual anterior drawer test, stress radiography, magnetic resonance imaging (MRI), and arthroscopy. |
Grade 3 lateral instability was verified arthroscopically in all 28 cases with a clinical diagnosis (100%). Twenty-two cases showed grade III instability on the manual anterior drawer test (78.6%). Twenty-four cases displayed anterior translation exceeding 5 mm on stress radiography (86%), and talar tilt angle exceeded 15 degrees in three cases (11 %). Nineteen cases displayed a partial chronic tear (change in thickness or signal intensity), and nine cases displayed complete tear on MRI (100%). Lax and wavy anterior talofibular ligament (ATFL) was evident on stress ultrasound in all cases (100 %). The mean value of the ATFL length was 2.8 +/- 0.3 cm for the stressed condition and 2.1 +/- 0.2 cm for the resting condition (p < 0.001). |
3 |
| 68. Tourne Y, Besse JL, Mabit C. Chronic ankle instability. Which tests to assess the lesions? Which therapeutic options? Orthop Traumatol Surg Res. 2010;96(4):433-446. |
Review/Other-Dx |
N/A |
To suggest an in-depth approach to diagnose the causes and lesions associated with and consecutive to chronic ankle instability due to ankle collateral ligament laxity. |
No results stated in abstract. |
4 |
| 69. Hoffman E, Paller D, Koruprolu S, et al. Accuracy of plain radiographs versus 3D analysis of ankle stress test. Foot Ankle Int. 2011;32(10):994-999. |
Observational-Dx |
20 lower extremity cadaver specimens |
To investigate the accuracy of plain film radiography in measuring translation of the talus during the AD test and the rotation of the talus during TT stress testing. In addition to determining the true accuracy of radiologic assessment in two planes, our goal was to further define instability in the sagittal, coronal and transverse planes. |
Mean positional changes determined by plain film radiographs were found to be significantly lower than those calculated by the three-dimensional system in both AD and TT tests in the intact and sectioned states (p < 0.001). |
3 |
| 70. Lee BH, Choi KH, Seo DY, Choi SM, Kim GL. Diagnostic validity of alternative manual stress radiographic technique detecting subtalar instability with concomitant ankle instability. Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1029-39. |
Observational-Dx |
120 patients. |
To incorporate a diagnostic technique for measuring subtalar motion, namely "talar rotation", into the manual supination-anterior drawer stress radiographs for evaluation of the severity of rotational instability, and to determine its clinical relevance. |
Ankle stress radiographic intraobserver and interobserver agreement was ICC = 0.91 and 0.82 for talar rotation (%), ICC = 0.64 and 0.51 for anterior talar translation, and ICC = 0.78 and 0.71 for talar tilt angle, respectively. In group 2 including patients with combined injuries of the ATFL and CFL along with additional cervical ligament insufficiency, a significantly higher increment of talar rotation, mean 6.4% (SD 3.4%), was observed compared to that of talar rotation, mean 4.1% (SD 2.7 ), in the other group (group 1) with an intact cervical ligament (p < 0.001). |
2 |
| 71. Lepojarvi S, Niinimaki J, Pakarinen H, Leskela HV. Rotational Dynamics of the Normal Distal Tibiofibular Joint With Weight-Bearing Computed Tomography. Foot Ankle Int. 37(6):627-35, 2016 Jun. |
Observational-Dx |
32 patients |
To investigate the normal anatomy and rotational dynamics of the distal tibiofibular joint under physiological conditions on weight-bearing cone beam computed tomography (WBCT). |
In the neutrally loaded ankle, the fibula was located anteriorly in the tibial incisura in 88% of the subjects. When the ankle was rotated, mean anteroposterior motion was 1.5 mm and mean rotation of the fibula was 3 degrees. There was no significant change in tibiofibular clear space (TFCS) between internal and external rotation. Large intersubject variation was detected, but intrasubject variation between ankles was less than 1 mm and 1 degree. |
4 |
| 72. Burssens A, Vermue H, Barg A, Krähenbühl N, Victor J, Buedts K. Templating of Syndesmotic Ankle Lesions by Use of 3D Analysis in Weightbearing and Nonweightbearing CT. Foot Ankle Int. 2018 Dec;39(12):1487-1496. |
Review/Other-Dx |
18 patients |
To develop a reproducible method to quantify the displacement of a syndesmotic lesion based on 3-dimensional computed imaging techniques. |
The main clinical relevant findings demonstrated a statistically significant difference between the mean mediolateral diastasis of both the sprained (mean [SD], 1.6 [1.0] mm) and the fracture group (mean [SD], 1.7 [0.6] mm) compared to the control group ( P < .001). The mean external rotation was statistically different when comparing the sprained (mean [SD], 4.7 [2.7] degrees) and the fracture group (mean [SD], 7.0 [7.1] degrees) to the control group ( P < .05). |
4 |
| 73. Hagemeijer NC, Chang SH, Abdelaziz ME, et al. Range of Normal and Abnormal Syndesmotic Measurements Using Weightbearing CT. Foot Ankle Int. 2019 Dec;40(12):1430-1437. |
Review/Other-Dx |
12 patients |
To evaluate both distal tibiofibular articulations using weightbearing computed tomography (CT) in patients with known syndesmotic instability, thereafter comparing findings between the injured and uninjured sides. |
Among those with unilateral syndesmotic instability, values differed between the injured and uninjured sides in 4 of the 7 measurements performed including the syndesmotic area: direct anterior, middle, and posterior differences, and sagittal translation (P < .001, < .001, < .001, and < .001, respectively). In the control population without ankle injury, no differences were identified between any of the bilateral measurements (P value range, .172-.961). |
4 |
| 74. Bhimani R, Ashkani-Esfahani S, Lubberts B, et al. Utility of Volumetric Measurement via Weight-Bearing Computed Tomography Scan to Diagnose Syndesmotic Instability. Foot Ankle Int. 2020 Jul;41(7):859-865. |
Review/Other-Dx |
12 |
Weight-bearing computed tomography (WBCT) allows evaluation of the distal syndesmosis under physiologic load. |
In patients with unilateral syndesmotic instability, all 3 weight-bearing volumetric measurements were significantly larger on the injured side as compared to the contralateral, uninjured side (P < .001). In the control group, there was no difference between syndesmotic volumes at any level. Of these 3 anatomic reference points, the 3D measurement spanning from the tibial plafond to a level 5 cm proximally had the highest relative volumetric ratio between the injured and uninjured side, suggesting it is the most sensitive in distinguishing between stable and unstable syndesmotic injury (P < .001). Notably, this 3D volumetric measurement was also more sensitive than 2D measurements (P = .001). |
4 |
| 75. Bhimani R, Ashkani-Esfahani S, Lubberts B, et al. Utility of WBCT to Diagnose Syndesmotic Instability in Patients With Weber B Lateral Malleolar Fractures. J Am Acad Orthop Surg. 2022 Feb 01;30(3):e423-e433. |
Observational-Dx |
23 patients |
To evaluate the ability of weight-bearing computed tomography (WBCT) to diagnose syndesmotic instability using one-dimensional, two-dimensional, and three-dimensional measurements among patients with unilateral Weber B lateral malleolar fractures with symmetric medial clear space (MCS) on initial radiographs and yet demonstrated operatively confirmed syndesmotic instability. |
Among patients with unilateral syndesmotic instability and Weber B ankle fractures, all WBCT measurements were significantly greater than uninjured side, except MCS distance, syndesmotic area, and anterior and posterior tibiofibular distances (P values <0.001 to 0.004). Moreover, syndesmosis volume spanning from the tibial plafond to 5 cm proximally had the largest area under the curve of 0.96 (sensitivity = 90%; specificity = 95%), followed by syndesmosis volume up to 3 cm proximally (area under the curve = 0.91; sensitivity = 90%; specificity = 90%). Except for MCS volume and distal fibular tip to tibial plafond distance, the control group showed no side-to-side difference in any parameter. |
4 |
| 76. Lee SJ, Jacobson JA, Kim SM, et al. Ultrasound and MRI of the peroneal tendons and associated pathology. [Review]. Skeletal Radiol. 42(9):1191-200, 2013 Sep. |
Review/Other-Dx |
N/A |
To review of the common causes of peroneal tendon pathology with particular reference to anatomy, US, and MRI features. |
No results stated in abstract. |
4 |
| 77. Ng JM, Rosenberg ZS, Bencardino JT, Restrepo-Velez Z, Ciavarra GA, Adler RS. US and MR imaging of the extensor compartment of the ankle. Radiographics. 33(7):2047-64, 2013 Nov-Dec. |
Review/Other-Dx |
N/A |
To discuss the normal anatomy and pathologic conditions of the ankle extensor compartment. US and MR imaging features as well as potential imaging pitfalls are presented. |
No results stated in abstract. |
4 |
| 78. Waitches GM, Rockett M, Brage M, Sudakoff G. Ultrasonographic-surgical correlation of ankle tendon tears. J Ultrasound Med. 1998;17(4):249-256. |
Observational-Dx |
33 patients |
Prospective study to evaluate the accuracy of US in diagnosing ankle tendon tears of the peroneal, posterior tibial, and flexor digitorum longus tendons based on operative findings and clinical follow-up. |
US had sensitivity 100%, specificity 88%, accuracy 93%, PPV 83%, NPV 100%. The combined accuracy, sensitivity, and specificity for US in detecting tendon tears in all patients evaluated both surgically and by clinical follow-up were 94%, 100%, and 90%, respectively. |
3 |
| 79. Nallamshetty L, Nazarian LN, Schweitzer ME, et al. Evaluation of posterior tibial pathology: comparison of sonography and MR imaging. Skeletal Radiol. 2005;34(7):375-380. |
Observational-Dx |
18 women; 22 ankles evaluated with US and MRI |
To compare the results of US and MRI in detecting pathology of the PTT in patients with PTT dysfunction. |
Based on a commonly accepted staging system for PTT dysfunction, 6 ankles were classified as stage I, 11 ankles as stage II, and 5 ankles as stage III. All stage I ankles were interpreted as having an intact PTT by both MR imaging and US. In the stage II and III tendons, MR imaging demonstrated PTT tears in 12 of 22 examinations, including 11 partial tears and 1 complete tear. US demonstrated PTT tears in 8 of 22 examinations, including 8 partial tears and no complete tears. The findings of US and MR imaging were consistent in 17 of 22 cases (77%). The five inconsistencies were as follows: in 4 cases, US reported tendinosis when MR imaging interpreted partial tears (no change in management); in one case, US diagnosed a partial tear when MR reported a complete tear of the PTT (no change in management because the clinical findings were more consistent with a partial tear). In this study, US and MR imaging of the PTT were concordant in the majority of cases. US was slightly less sensitive than MR imaging for PTT pathology, but these discrepancies did not affect clinical management. |
3 |
| 80. Grant TH, Kelikian AS, Jereb SE, McCarthy RJ. Ultrasound diagnosis of peroneal tendon tears. A surgical correlation. J Bone Joint Surg Am. 2005;87(8):1788-1794. |
Observational-Dx |
58 patients |
Prospectively evaluate patients to determine whether US is effective for evaluating peroneal tendon injuries, with surgical findings used as the standard of reference. |
Of 60 tendons evaluated operatively, 25 were torn. The sensitivity, specificity, and accuracy of US were 100%, 85%, and 90%, respectively. Dynamic US should be considered a first-line diagnostic tool. The use of dynamic US is effective for determining the presence or absence of a peroneal tendon tear and should be considered a first-line diagnostic tool. |
3 |
| 81. Astrom M, Gentz CF, Nilsson P, Rausing A, Sjoberg S, Westlin N. Imaging in chronic achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases. Skeletal Radiol. 1996;25(7):615-620. |
Observational-Dx |
27 patients |
To compare US and MRI in chronic achilles tendinopathy with regard to the nature and severity of the lesion. Both perative findings and histological biopsies were used as reference. |
Surgical findings included 4 partial ruptures, 21 degenerative lesions and 2 macroscopically normal cases. Microscopy revealed tendinosis (degeneration) in all tendon biopsies, including cases with a partial rupture, but only slight changes in the paratendinous tissues (paratenon). US was positive in 21 of 26 and MRI in 26 of 27 cases. Severe intratendinous abnormalities and a sagittal tendon diameter > 10 mm suggested a partial rupture. In tendons with a false negative result histopathological changes were mild and a tendency towards a better clinical outcome was noted in the sonographic cases. Assessment of the paratenon was unreliable with both methods. US and MRI give similar information and may have their greatest potential as prognostic instruments. |
3 |
| 82. Hartgerink P, Fessell DP, Jacobson JA, van Holsbeeck MT. Full- versus partial-thickness Achilles tendon tears: sonographic accuracy and characterization in 26 cases with surgical correlation. Radiology. 2001;220(2):406-412. |
Observational-Dx |
26 patients |
To determine the accuracy of the use of sonography for differentiation of full- from partial-thickness tears or tendinosis of the Achilles tendon by using surgical findings as the standard of reference and to identify sonographic characteristics of full-thickness tears that can be used to differentiate the two types of tears. |
In part A, statistical data regarding the use of sonographic findings to distinguish full- from partial-thickness tears were as follows: sensitivity, 100%; specificity, 83%; accuracy, 92%; PPV, 88%; and NPV, 100%. In part B, tendon thickness (P <.001), posterior acoustic shadowing (P =.007), and tendon retraction (P <.001) were correlated with full-thickness tears. Visualization of fat herniation (P =.051) and of the plantaris tendon (P =.098) demonstrated marginal correlation with full-thickness tears. Echogenicity at the site of the pathologic finding in the tendon showed no significant correlation. Sonography can be used to differentiate full- from partial-thickness tears or tendinosis of the Achilles tendon with 92% accuracy. Undetectable tendon at the site of injury, tendon retraction, and posterior acoustic shadowing demonstrate statistically significant correlation with full-thickness tears. |
3 |
| 83. Rosenberg ZS, Cheung Y, Jahss MH, Noto AM, Norman A, Leeds NE. Rupture of posterior tibial tendon: CT and MR imaging with surgical correlation. Radiology. 1988;169(1):229-235. |
Observational-Dx |
27 patients with 32 clinically suspected posterior tibial tendon ruptures 23 controls ; 46 CT and MRI studies reviewed. |
To compare accuracy of CT and MRI for posterior tibial tendon (PTT) rupture using surgery as the gold standard. |
For CT: Sensitivity 90%, specificity 100%. For MRI: Sensitivity 95%, specificity 100%. The accuracy in detecting ruptures was 91% for CT and 96% for MRI. The overall accuracy, which reflected the percentage of cases correctly diagnosed as well as those correctly classified, was 59% for CT and 73% for MRI. MRI is the method of choice for detecting ruptures of the PPT. It provided greater definition of tendon outline, vertical splits, synovial fluid, edema, and degenerated tissue. CT was superior to MRI in showing associated bone abnormalities. |
3 |
| 84. Park HJ, Cha SD, Kim HS, et al. Reliability of MRI findings of peroneal tendinopathy in patients with lateral chronic ankle instability. Clin Orthop Surg. 2010;2(4):237-243. |
Observational-Dx |
82 patients |
To assess the reliability of MRI by comparing MRI findings and operative findings of peroneal tendinopathy in patients with chronic lateral ankle instability. |
Of the 82 cases, 26 were true positives, 38 true negatives, 13 false positives and 5 false negatives. Of 39 cases of peroneal tendinopathy diagnosed from MRI, 14 had peroneal tendon partial tears, 15 tenosynovitis, 3 dislocations, 17 low-lying muscle bellies, and 6 peroneus quartus muscles. Of 31 cases of peroneal tendinopathy observed in surgery 11 had peroneal tendon partial tears, 4 tenosynovitis, 5 dislocations, 12 low-lying muscle belliess, and 1 peroneus quartus muscle. Sensitivity and specificity of peroneal tendinopathy were 83.9% and 74.5%, respectively. PPV was 66.7%. NPV was 88.4%. Accuracy rate was 78.0%. MRI is a useful diagnostic tool for detecting peroneal tendinopathy in patients with chronic lateral ankle instability. However, MRI is vague in many cases. Therefore, a thorough delicate physical examination and careful observation is needed. |
3 |
| 85. Saxena A, Luhadiya A, Ewen B, Goumas C. Magnetic resonance imaging and incidental findings of lateral ankle pathologic features with asymptomatic ankles. J Foot Ankle Surg. 50(4):413-5, 2011 Jul-Aug. |
Review/Other-Dx |
100 patients |
To study the incidence of lateral ankle pathologic features visualized in asymptomatic individuals. |
Of the 100 patients, 67 (66%) had no history of a lateral ankle sprain, and 35 (34%) had sustained 1 or more sprains in the remote past. Also, 72 had an intact anterior talofibular ligament (71%), 90 had an intact calcaneofibular ligament (89%), 67 had intact peroneus brevis tendons (66%), and 68 (67%) had intact peroneus longus tendons. One accessory peroneal tendon was noted. Approximately 30% of asymptomatic patients undergoing MRI had abnormal anterior talofibular ligaments and peronei. |
4 |
| 86. Roth JA, Taylor WC, Whalen J. Peroneal tendon subluxation: the other lateral ankle injury. Br J Sports Med. 2010;44(14):1047-1053. |
Review/Other-Dx |
N/A |
Review current literature on peroneal tendon subluxation and propose a clinical algorithm to help guide diagnosis and treatment. Study goal was to heighten clinical awareness to improve earlier detection and treatment of disease. |
MRI is the best imaging modality to view the peroneal tendons at the retrofibular groove. Currently, point-of-care ultrasound is gaining clinical ground, especially for the dynamic viewing capability to capture an episodic subluxation. |
4 |
