New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test, stress radiography and stress ultrasound

Lee, Kyung Tai; Park, Young Uk; Jegal, Hyuk; Park, Jong Won; Choi, Jung Pil; Kim, Jin Su

doi:10.1007/s00167-013-2690-x

Cited by 92 publications

(79 citation statements)

References 31 publications

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“…Comparing US results of healthy people and patients with chronic ankle instability, Liu et al reported the differences in the thickness of ATFL [ 51 ] and Croy et al reported differences in the length of ATFL [ 52 ]. Lee et al recommended stress US over regular one for diagnosis of chronic lateral ankle ligament injury [ 53 ]. The study of Cho et al, which was included in the current review [ 38 ], utilized stress US.…”

Section: Discussionmentioning

confidence: 99%

Imaging diagnosis for chronic lateral ankle ligament injury: a systemic review with meta-analysis

Cao

Wang

et al. 2018

J Orthop Surg Res

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BackgroundVarious imaging techniques have been utilized for the diagnosis of chronic lateral ankle ligament injury. This systemic review will explore the effectiveness of different imaging techniques in diagnosing chronic lateral ankle ligament injury.MethodsRelative studies were retrieved after searching 3 databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. Data were extracted to calculate pooled sensitivity and specificity of magnetic resonance imaging (MRI), ultrasonography (US), stress radiography, and arthrography.ResultsFifteen studies met our inclusion and exclusion criteria. A total of 695 participants were included. The pooled sensitivities in diagnosing chronic ATFL injury were 0.83 [0.78, 0.87] for MRI, 0.99 [0.96, 1.00] for US, and 0.81 [0.68, 0.90] for stress radiography. The pooled specificities in diagnosing chronic ATFL injury were 0.79 [0.69, 0.87] for MRI, 0.91 [0.82, 0.97] for US, and 0.92 [0.79, 0.98] for stress radiography. The pooled sensitivities in diagnosing chronic CFL injury were 0.56 [0.46, 0.66] for MRI, 0.94 [0.85, 0.98] for US, and 0.90 [0.73, 0.98] for arthrography. The pooled specificities in diagnosing chronic CFL injury were 0.88 [0.82, 0.93] for MRI, 0.91 [0.80, 0.97] for US, and 0.90 [0.77, 0.97] for arthrography.ConclusionThis systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of chronic lateral ankle ligament injury. Ultrasound manifested high diagnostic accuracy in diagnosing chronic lateral ankle ligament injury. Clinicians should be aware of the limitations of MRI in detecting chronic CFL injuries.

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Section: Discussionmentioning

confidence: 99%

Imaging diagnosis for chronic lateral ankle ligament injury: a systemic review with meta-analysis

Cao

Wang

et al. 2018

J Orthop Surg Res

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“…Hedelin et al revealed that fractures could be examined dynamically to see whether the fractured bone was moving. Lee et al reported that a dynamic scan could be used to diagnose fractures as well as ligament instability. The reason for the increases in fracture detection is because sonography shows widening of the fracture space during the dynamic stress scan.…”

Section: Discussionmentioning

confidence: 99%

Color Doppler Sonography Accompanied by Dynamic Scanning for the Diagnosis of Ankle and Foot Fractures

Park

Youn³

et al. 2017

J of Ultrasound Medicine

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Sonography is conventionally used to diagnose fractures by identifying cortical discontinuity of the bone. In this study, fracture sonography in addition to color Doppler and dynamic scanning was performed in settings with limited or no access to radiography. We describe 5 cases of ankle and foot fractures with the use of sonography to identify changes in the fractured site. The width of the fracture space increased on dynamic scanning, and the Doppler signals were generated inside the fracture space on dynamic scanning. In conclusion, color Doppler sonography accompanied by dynamic scanning is a useful adjunctive diagnostic tool in addition to previously described sonographic fracture findings.

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“…Detection of chondral fractures in a static condition using sonography and MRI is difficult. However, sonography is a strong tool for use in dynamic conditions and can hence enable the detection of abnormal motion of chondral lesions and mobility of hyperechoic spots along the site of a chondral fracture. Accordingly, the direct diagnosis of chondral fractures is possible by using this modality.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, modern high‐frequency ultrasound transducers used by experienced examiners can provide unsurpassed resolution of the superficial musculoskeletal structures in children . Furthermore, sonography is effective for use in dynamic states, and stress sonography during a manual anterior drawer stress procedure has great specificity in terms of detecting minor instability . When dynamic stress is applied, sonography can easily identify abnormal motion related to chondral fractures.…”

mentioning

confidence: 99%

Sonographic Findings of Chondral Avulsion Fractures of the Lateral Ankle Ligaments in Children

Maeda¹,

Maeda²,

Takaoka

et al. 2017

J of Ultrasound Medicine

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In this series, we aimed to describe the sonographic findings of chondral avulsion fractures that develop concomitant with lateral ankle ligament injury in children. We performed stress sonography during a manual anterior drawer stress procedure of the ankle in 9 skeletally immature patients who had recently had a lateral ankle sprain. Echo videos were obtained through the course of treatment, and all videos were reviewed. We elucidated the common features of chondral avulsion fractures of the lateral ankle ligaments in the children. The features of avulsion fractures on conventional sonography included absence of a fracture with hyperechoic spots (sonographic occult fracture type), cortical discontinuity with hyperechoic spots (cortical disruption fracture type), fracture line in the cortical bone (double-line fracture type), and a step-off deformity of the cortical bone with cartilage (displaced fracture type). In contrast, the features of chondral fractures on stress sonography included abnormal motion of the chondral lesions and mobility/fluidity of hyperechoic spots along the chondral fracture site. The presence of hyperechoic spots around the chondral lesion is an important sonographic sign for diagnosing chondral fractures concomitant with ankle lateral ligament injury. Hence, we believe that stress sonography should be considered for the detection of chondral fractures concomitant with radiographically negative ankle lateral ligament injuries in skeletally immature patients with lateral ankle pain and ankle sprains, if hyperechoic spots are present in the cartilage of the distal fibula.

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New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test, stress radiography and stress ultrasound

Abstract: The results suggest that the value of ATFL length (ATFL stress) and ATFL ratio of stress ultrasound could be used for diagnosis of chronic ankle instability in addition to manual anterior drawer test and stress radiography.

Cited by 92 publications

References 31 publications

Imaging diagnosis for chronic lateral ankle ligament injury: a systemic review with meta-analysis

Imaging diagnosis for chronic lateral ankle ligament injury: a systemic review with meta-analysis

Color Doppler Sonography Accompanied by Dynamic Scanning for the Diagnosis of Ankle and Foot Fractures

Sonographic Findings of Chondral Avulsion Fractures of the Lateral Ankle Ligaments in Children

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