Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Deltoid Ligament and Tibiofibular Syndesmosis Injury in Chronic Lateral Ankle Instability: Magnetic Resonance Imaging Evaluation at 3T and Comparison with Arthroscopy

  • Chun, Ka-Young (Department of Radiology, Eulji Hospital, Eulji University) ;
  • Choi, Yun Sun (Department of Radiology, Eulji Hospital, Eulji University) ;
  • Lee, Seok Hoon (Department of Radiology, Eulji Hospital, Eulji University) ;
  • Kim, Jin Su (Department of Orthopedic Surgery, Eulji Hospital, Eulji University) ;
  • Young, Ki Won (Department of Orthopedic Surgery, Eulji Hospital, Eulji University) ;
  • Jeong, Min-Sun (Department of Radiology, Eulji Hospital, Eulji University) ;
  • Kim, Dae-Jung (Department of Radiology, Eulji Hospital, Eulji University)
  • Received : 2014.12.11
  • Accepted : 2015.06.02
  • Published : 2015.09.01
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Abstract

Objective: To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI). Materials and Methods: Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard. Results: On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively. Conclusion: Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential.

Keywords

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