Value of arthrography after supination trauma of the ankle.
OBJECTIVE
To investigate the merits of arthrography after supination trauma of the ankle.


METHODS
In a group of 160 consecutive patients operative exploration was performed in cases where arthrography and/or a delayed physical examination showed positive findings. In all patients arthrography was performed within 48 h after trauma. To determine interobserver agreement, all arthrograms were independently evaluated by two radiologists, both ignorant of the first assessment.


RESULTS
The prevalence of an ankle ligament lesion was found to be 76%. Of the 122 patients with a rupture of one or more ankle ligaments, 52% had an isolated anterior talofibular ligament lesion, 3% had an isolated calcaneofibular ligament lesion, and 45% had combined lesions. The site of the lesion was predominantly intraligamentous. In the determination of the presence or absence of an ankle ligament lesion, the specificity and sensitivity of the ankle arthrogram were 71% and 96% respectively. Interobserver agreement on the arthrogram was very good (kappa 0.9). In 1% of patients a clear diagnosis was not possible by means of arthrography.


CONCLUSIONS
Arthrography provides information of high diagnostic quality with excellent interobserver agreement and therefore remains the gold standard for early diagnosis (within 48 h) of a lateral ankle ligament rupture.
van Dijk
C N
CN
Department of Orthopaedic Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Molenaar
A H
AH
Cohen
R H
RH
Tol
J L
JL
Bossuyt
P M
PM
Marti
R K
RK
D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D001175:Arthrography; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006395:Hemarthrosis / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D015588:Observer Variation; D010808:Physical Examination; D011237:Predictive Value of Tests; D015995:Prevalence; D012421:Rupture; D012680:Sensitivity and Specificity; D013180:Sprains and Strains / Q000000981:diagnostic imaging* / Q000601:surgery; D013484:Supination
D003287:Contrast Media