Clinical diagnosis of syndesmotic ankle instability

Beumer, Annechien; Swierstra, Bart A; Mulder, Paul

doi:10.3109/17453670209178033

Cited by 5 publications

(2 citation statements)

References 6 publications

(5 reference statements)

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“…Clinical examinations that assess ankle syndesmosis include palpation of the tibiofibular ligaments [8,9,10], dorsiflexion with external rotation stress test [3,11], the squeeze test [6,12], Cotton test [10,13], and fibula translation test [11,12,13,14]. However, these clinical examinations are still questioned in terms of reliability and accuracy, and there is a limit to diagnosing ankle syndesmosis based only on these tests.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Radiologic Methods for Ankle Syndesmosis Injury: A Systematic Review and Meta-Analysis

Chun

Cho

Min

et al. 2019

JCM

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: Misdiagnosis and inadequate treatment of syndesmosis could result in significant long-term morbidity including pain, instability, and degenerative changes of the ankle joint. The objective of this systematic review and meta-analysis was to determine whether radiologic tests accurately and reliably diagnose ankle syndesmosis injury. Medline, Embase, and Cochrane were searched. The database search resulted in 258 full text articles that we assessed for eligibility, we used eight studies that met all the inclusion criteria. In subgroup meta-analysis, the sensitivity analysis showed significant differences only in the MRI (Magnetic Resonance Imaging), and specificity was not statistically significant. In diagnostic meta-analysis, the pooled sensitivity and specificity were 0.528 and 0.984 for X-rays, 0.669 and 0.87 for CT (Computed Tomography), and 0.929 and 0.865 for MRI, all respectively. For sensitivity, MRI showed significantly sensitivity as higher than the other methods, and we detected no significance for specificity. Syndesmosis injuries differed significantly in the accuracy of radiological methods according to the presence of accompanied ankle fractures. In patients with fractures, simple radiography has good specificity, and CT and MRI have high sensitivity and specificity irrespective of fracture; in particular, MRI has similar accuracy to gold standard arthroscopic findings.

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