Comparative assessment of the acute ankle injury by ultrasound and magnetic resonance (original) (raw)
Related papers
The Value of Ultrasound in Acute Ankle Injury: Comparison With MR
European Journal of Trauma and Emergency Surgery, 2008
Objective: To assess the value of the ultrasound (US) in different grades of acute trauma by comparing with MR. Methods: We analyzed 30 patients, of average age 33, with acute ankle trauma, without fracture on standard radiograms. One week after injury all patients were sent for US. We used linear probe 8-15 MHz. Ten days later, the patients were examined on MR. Results: Anterior talofibular ligament was normal in 20.6% by US and in 20.3% by MR. Ligament lesion were found by ultrasound in 40%, proven in only 20.6% by MR. Ultrasound diagnosed 33,3% ruptured ligament, MR found 50% rupture of anterior talofibular ligament. In 80.3% cases the calcaneofibular ligament appeared to be intact with both methods. Ultrasound found stretch ligament in 10.6% cases and MR proved that in 10% cases. In other 6.6% cases, MR found complete rupture. Intraarticular effusion was found in 80.3% patients by US and in 86.6% by MR. Lesion of tendon of long peroneal muscle was found in 40.6% patients by both methods. Lesion of tendon of short peroneal muscle was found in 33.3% lesions and proved by MR in only 20.3% cases. In other patients findings were normal. US found 10% lesions of the tendon of anterior tibial muscle and MR found 10.3% lesions. US found 10.6% lesions of tendon of long halucis flexor and MR found 20%. Our results were statistically analyzed by cross-tabs, the Stuart-Maxwell test, Npar tests and the McNemar test. Conclusion: US proved to be a good and reliable method for diagnosing Grade I and II of ankle sprain, but for proper evaluation of Grade III, MR is recommended.
Magnetic resonance imaging of injuries to the ankle joint: can it predict clinical outcome?
Skeletal Radiology, 1997
Objective. To predict clinical outcome after ankle sprains on the basis of magnetic resonance (MR) findings. Design and patients. Twenty-nine consecutive patients (mean age 32.9 years, range 13-60 years) were examined clinically and with MR imaging both after trauma and following standardized conservative therapy. Various MR abnormalities were related to a clinical outcome score. Results. There was a tendency for a better clinical outcome in partial, rather than complete, tears of the anterior talofibular ligament and when there was no fluid within the peroneal tendon sheath at the initial MR examination (P=0.092 for either abnormality). A number of other MR features did not significantly influence clinical outcome, including the presence of a calcaneofibular ligament lesion and a bone bruise of the talar dome. Conclusion. Clinical outcome after ankle sprain cannot consistently be predicted by MR imaging, although MR imaging may be more accurate when the anterior talofibular ligament is only partially torn and there are no signs of injury to the peroneal tendon sheath.
Role of Magnetic Resonance Imaging in Evaluation of Traumatic Ankle Injuries
Background: Ankle trauma is commonly encountered and is most often a sprain injury affecting the ligaments. Accurate diagnosis and appropriate treatment rest on knowledge of complex ligamentous anatomy of ankle and the entire spectrum of pathologies. Magnetic resonance imaging (MRI) is the imaging modality of choice for diagnosing ligament pathologies because of its multiplanar capability and high soft tissue contrast. With MRI, it is possible to triage and attribute the cause of post traumatic ankle pain to bone, ligament, or tendon pathologies, which otherwise overlap clinically. Materials and Methods: Fifty patients with clinical suspicion of traumatic ankle injuries referred to the Department of Radio-Diagnosis from November 2018 to May 2020 underwent MRI of ankle. The main source of data for the study were patients from Victoria Hospital, Bowring and Lady Curzon Hospital and Vani Vilas hospital attached to Bangalore Medical College and Research Institute, Bengaluru. All MR imaging examinations were performed on a Siemens 1.5-T MagnetomAvanto MR system. Protocol of MRI ankle used in the study: Axial T1W / TSE, Axial T2W / TSE, Axial-STIR / TSE, Sagittal T2W / TSE, Sagittal STIR / TSE, Coronal T1W / TSE, Coronal T2W / TSE, Coronal STIR / TSE images were obtained in all the patients. Results: Among the 50 patients, 28% of the cases were found to be normal and 72% had findings. Ankle joint effusion (50%) was the most common finding seen, followed by ligament injuries (38%) tendon injuries (20%) and osseous injuries (20%). ATFL (45%) was the most commonly injured ligament followed by PTFL (17%) and deltoid ligament (14%) injuries. Sprain (53%) was the most common type of ATFL injury followed by complete tear (26%) and partial tear (21%). Tibionavicular (21%) and tibiocalcaneal (21%) were the most common ligaments injured in deltoid ligament. FHL (30%) and tibilalis posterior (30%) were the most common tendons injured. Bone contusion was the most common osseous injury (61%) followed by fractures (31%) and joint dislocation (8%). Conclusion: MRI was found to be a key modality to evaluate various soft tissue injuries of the ankle and to arrive at an accurate diagnosis. Characterization of the lesions and awareness of the common pathologies will help the clinician arrive at an informed differential diagnosis. MRI is a non-invasive imaging modality with no radiation hazard, excellent resolution and multiplanar imaging capability. Use of prompt imaging will be helpful to accurately diagnose the soft tissue injuries of the ankle.
Magnetic resonance imaging of injury to the lateral ankle ligaments
The American Journal of Sports Medicine, 1993
To establish the value of magnetic resonance imaging in determining which patients with ankle sprains will benefit from surgical treatment, 1 uninjured volunteer and 15 patients with acute, subacute, and chronic injuries of the lateral ankle ligaments were imaged at 1.0 tesla using a fast imaging with steady-state preci sion three-dimensional technique and 1.5-mm slice thickness. A dedicated knee coil was used to hold the foot in a neutral or plantar-flexed position. In cases of acute, low-grade injuries, fraying of the anterior talofib ular ligaments with intact calcaneofibular ligaments was observed in the presence of edema and hemorrhagic fluid. In cases of acute, high-grade sprains, the calca neofibular ligament appeared wavy or was visualized only partially or not at all. Subacute injuries showed ligament disruption; chronic lesions, on occasion, showed atrophy of the calcaneofibular ligament but no edema or hemorrhagic fluid. These findings showed a good qualitative correlatio...
Ultrasound of Ankle and Foot: Overuse and Sports Injuries
Seminars in Musculoskeletal Radiology, 2007
Sports and overuse injuries of the ankle and foot are commonly encountered in clinical practice. Ultrasound (US) has been established as an excellent diagnostic modality for foot and ankle injuries, providing a rapid noninvasive, economical, and readily available tool that is well tolerated by the patient with acute or chronic pain. The opportunity for dynamic examination is another advantage of US in evaluating ankle and foot pathology, where maneuvers such as muscle contraction and stressing of the joint may be particularly helpful. In many cases, US can be used as a first-line and only imaging modality for diagnosis. This article focuses on ankle disorders related to sports or overuse that affect tendons, including tendinosis, tenosynovitis, paratendinitis, rupture, dislocation, and ligaments that are commonly torn. The sonographic features of certain common foot disorders related to physical activity and overuse are also discussed, including plantar fasciitis, Morton's neuroma, stress fractures, and plantar plate injury.
Journal of Ultrasound, 2021
Lateral Ankle sprain is a common sports-related trauma with the mechanism of injury ranging from inversion to plantar flexion. These injuries commonly affect the ligaments but can also affect the associated soft tissue structures like the eversion muscles and tendons. Prompt and accurate diagnosis of such injuries is warranted so as to ensure early return to play and prevent long-term complications. Lateral ankle sprain injuries in sports may not always be associated with ligament injuries. We report a never before reported case of lateral ankle sprain injury in a soccer player with the unusual finding of isolated partial tear of Extensor digitorum longus muscle and its fascia leading to myo-fascial herniation. The lateral ankle ligaments were intact. The diagnosis was clinched on a high-frequency ultrasound scan supported by dynamic maneuvers which in fact proved to be superior to MRI as the latter failed to demonstrate the myo-fascial herniation in our case. We therefore propose t...