The stress-tenogram in the diagnosis of ruptures of the lateral ligament of the ankle

Abstract

The stress-tenogram is a radiological technique for the investigation of injuries to the lateral ligament of the ankle, and combines the information previously provided by inversion and anterior stress radiographs, and the peroneal tenogram. It is designed to differentiate between stable and unstable ankles, and between isolated ruptures of the anterior talofibular ligament and combined tears of the anterior talofibular and calcaneofibular ligaments. A high degree of diagnostic accuracy has been confirmed at operative repair in a group of thirty-two patients.

Fluid in normal and abnormal ankle joints: amount and distribution as seen on MR images.

“…In our experience, the amount and distribution of joint fluid seen on MR images may be similar in normal and abnormal ankles. This led us to believe that the fluid in the ankle seen on MR images should not be considered abnormal, as has been stated [1][2][3][4][5]. To test this hypothesis, we studied the amount and distribution of fluid seen on MR images of both normal and abnormal ankles.…”

Rupture of the ankle ligaments

“…The diagnosis was reviewed when stress tenography [5] was carried out 24-48 h after injury. The radiologist had to decide in the 189 patients examined initially at our institution whether there was a single or double tear present, based on the presence of contrast medium in the joint (Fig.…”

National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

“…Arthrography and tenography are less accurate than MRI and CT, especially when performed 48 hours after lateral ligamentous injury. 18,19 Evidence Category: B 13. After acute trauma, MRI has high sensitivity, specificity, and accuracy to determine the level of injury to the ankle syndesmotic ligaments.…”

“…The accuracy of ankle arthrography ranges from 65% to 96%, 18 and the accuracy of peroneal tenography to detect rupture of the CFL ranges from 83% to 95%. 19 Disadvantages of arthrography include reduced accuracy 48 hours after trauma, the invasive nature of the procedure, and the lack of direct visualization of the injured ligaments. 18 As the preferred imaging technique to detect ligament rupture after ankle sprain, MRI has replaced arthrography.…”