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Dynamic Ankle Ultrasonography

A New Imaging Technique for Acute Ankle Ligament Injuries

Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, Adelaide, South Australia

Anthony Menz, MB, BS, FRACS, FAOrthA

Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, Adelaide, South Australia

John Isaacs, MB, BS, FRCR, MRCP

Department of Radiology, Royal Adelaide Hospital, Adelaide, South Australia

We have developed a noninvasive ultrasound tech nique that may be used to differentiate complete and incomplete acute tears of the anterior talofibular liga ment. Direct visualization of the ligament will demon strate the lesion in most cases and can be supple mented by an anterior drawer test with the ligament under direct vision. Seventeen athletes involved in sports and work that put high-demand pressure on their ankles underwent ultrasonic examination of their acute lateral ankle ligament injuries before surgical explora tion. Fourteen scans demonstrating a complete lesion of the anterior talofibular ligament were confirmed at operation. Three scans were equivocal; two of these patients had incomplete lesions of their anterior talo fibular ligaments and one patient had a complete tear that was not detected. We have found that the dynamic ultrasound test is a simple and reliable examination. We suggest that this technique is indicated where the extent of an acute lateral ligament injury requires further defi nition. Ankle ultrasonography may reduce the need for ankle arthrography.

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