Value of MRI in Diagnosing Injuries after Ankle Sprains in Children

Abstract

The injury patterns diagnosed through MRI examination did not correlate with clinical findings. With adequate progressive rehabilitation, the pathological changes diagnosed with MRI healed without further complications. MRI examinations of acute ankle distortion injuries in children did not result in any additional therapeutic value. Therefore, we believe conventional clinical, radiological, and ultrasound diagnostic methods are sufficient for the primary diagnosis of ankle fractures and ankle ligament injuries in children.

The proportion of distal fibula Salter–Harris type I epiphyseal fracture in the paediatric population with acute ankle injury

“…Reviewing the literature, we only found four studies in which MRI was the primary modality used to visualize SH1FDF [1,2,7,8].…”

“…It is well-known that MRI examinations can detect ligamentous and chondral ankle injuries with high specificity and sensitivity [2]. However, the use of MRI has its limitation in children under 5 years or children who cannot cooperate, and hence the procedure has to be conducted under conscious sedation or general anaesthesia.…”

“…Ankle sprains occur frequently in children [1][2][3]. In cases where there are clinical signs (swelling and tenderness directly over the distal fibular physis) but no radiological evidence of fracture of the distal fibula, it is a common practice to treat the patient as having Salter-Harris type I fracture of the distal fibula (SH1FDF) [4].…”

Football injuries of the ankle: A review of injury mechanisms, diagnosis and management

“…While standard radiographs are effective in diagnosing the presence of anterolateral osteophytes, MRI can reveal soft tissue impingement [74][75][76] . However, as false-negative results have been reported with MRI, arthroscopy is generally advocated as the definitive diagnostic and therapeutic modality [71,77] .…”

“…An oblique AMI view (45° craniocaudal, 30° external rotation of the leg with the ankle in full plantarflexion) is recommended when plain radiographs are negative as it can provide specific visualization of anteromedial osteophytes (Figure 9) [75] . CT may aid in confirming the diagnosis and MRI can identify soft-tissue impingement, soft tissue injuries, or OCL's [76] . Ultrasound-guided corticosteroid injections can reduce the patients symptoms temporarily, however, definitive treatment is typically achieved surgically [84] .…”