title: Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma.
abstract: We prospectively enrolled 160 consecutive patients with inversion trauma of the ankle in a diagnostic protocol that included physical examination within 2 days and at 5 days after trauma, arthrography, stress radiography, and ultrasonography. 135 patients had pathological lateral ligament laxity on the later physical examination or lateral ligament rupture diagnosed on arthrography and they were operated on 122 of these patients had ligament ruptures. At clinical follow-up after a minimum of half a year, all of the patients who were not operated on had stable joints without signs of previous ligament ruptures. Delayed physical examination at 5 days after the injury led to the highest overall sensitivity (96%) and specificity (84%) for the detection of a ligament rupture. Additional diagnostic procedures, at a considerable cost, yielded little additional information.
authors.affiliation: Department of Orthopedics, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: C N
authors.initials: CN
authors.lastname: van Dijk
authors.forename: B W
authors.initials: BW
authors.lastname: Mol
authors.forename: L S
authors.initials: LS
authors.lastname: Lim
authors.forename: R K
authors.initials: RK
authors.lastname: Marti
authors.forename: P M
authors.initials: PM
authors.lastname: Bossuyt
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis*; D001175:Arthrography; D003365:Costs and Cost Analysis; D003661:Decision Support Techniques; D003952:Diagnostic Imaging / Q000191:economics; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries* / Q000502:physiology; D010808:Physical Examination / Q000191:economics; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography