MR imaging of the most commonly injured ankle ligaments. Part II. Ligament injuries.

Abstract

Thirteen patients with clinically diagnosed sprained ankles underwent magnetic resonance (MR) imaging. Five of these cases are presented to illustrate the potential of MR imaging to enable identification of both primary and associated ligament injury sites, grading of the severity of the injuries, and visualization of the associated findings of tendon sheath and joint effusion. The appropriate combination of foot position and imaging plane is essential to achieve full-length visualization of each ligament. Two patients demonstrated findings compatible with total gross disruption of the anterior fibulotalar ligament; two, with injury to the fibulocalcaneal ligament with effusion of the overlying peroneus tendon sheath; and one, with thinning, lengthening, and fibrotic changes involving the anterior fibulotalar ligament. MR imaging can provide a noninvasive means to evaluate the site and severity of ankle ligament injuries (a) in acute ankle injuries that demonstrate significant instability, (b) in stable acute injuries involving athletes or litigation, or (c) in patients with repeated injuries or instability in whom surgery is contemplated.

Incidence and clinical significance of bone bruises after supination injury of the ankle

“…MRI can detect subtle injuries of cartilage and osteochondral bone. [3][4][5][6] Damage to cartilage may lead to a lesion of subchondral bone seen as a bone bruise on MRI. 7 The articular cartilage may appear to be intact 8 and such lesions may represent elastic deformation of the cartilage with haemorrhage and disruption of the trabecular bone.…”

Quantitative Assessment and Ligament Traceability of Volume Isotropic Turbo Spin Echo Acquisition (VISTA) Ankle Magnetic Resonance Imaging: Fat Suppression versus without Fat Suppression

“…As the time goes by, ligaments typically heal through filling of the defect with a fibrous scar, which begins to form via fibroblastic proliferation as early as 7 days after the injury (28). And further remodeling of the fibrous scar goes on as the resolving hematoma and disorganizing matrix with the areas containing fat cells, vascular structure and clusters of mononuclear cells (27,33). Although at a certain point of this time course, fat-suppressed MR image would be helpful in the evaluation of ankle ligament tear, but when there is no hemorrhage or fluid collection in chronic status, the validity of fat suppression is doubtful and the role of MRI in evaluation chronic injury might become depicting ligament irregularity or thickening, heterogeneity of ligament signal and ligament visibility (34,35).…”

Sports Injuries of the Ankle

“…Standard radiographs are frequently normal. The sensitivity of MRI to detect deltoid lesions is high (Schneck et al 1992 ). However, there is a risk of overdiagnosing deltoid ligament lesionsdeltoid ligament abnormalities after a classical inversion trauma (with lateral ligaments injuries) are reported to be present in 60 % of the cases, but this frequently does not align with the clinical fi ndings.…”