title: Ankle laxity: stress investigation under MRI control.
abstract: OBJECTIVE
  The purpose of this study was to examine the advantages of MRI-guided ankle stress examinations in the detection of chronic ankle instability.
  
  
  METHODS
  An MRI-compatible stress device was developed and tested for MRI safety. Bilateral MRI stress examinations were performed on 50 volunteers with and without clinically evident subjective instability of the ankle joints (72 subjective stable ankle joints in 37 subjects, 28 ankles in 15 subjects with chronic ankle instability). Both the inversion test and the anterior drawer test were performed under axial, coronal, 45° paraxial, and sagittal T2-weighted fast spin-echo image control. MR images were assessed for talar tilt, subtalar tilt, anterior talus translation, anterior calcaneus translation, medial talocalcaneal translation, and the diameters of the lateral ankle ligaments (anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament).
  
  
  RESULTS
  The MRI stress device was found suitable and safe for use in the MRI environment. The talocrural and subtalar joints could be assessed simultaneously. Significant differences between groups A and B (p≤0.05) were found in talar tilt, subtalar tilt, anterior talus translation, anterior calcaneus translation, medial talocalcaneal translation, and decrease in diameters of calcaneofibular and posterior talofibular ligaments. Also found were sex differences in talar tilt, subtalar tilt, anterior talus translation, and diameters of the anterior talofibular, calcaneofibular, and posterior talofibular ligaments. Significant relations were found between talar tilt and anterior talus translation, subtalar tilt and anterior calcaneus translation, subtalar tilt and medial talocalcaneal translation, and between anterior calcaneus translation and medial talocalcaneal translation in groups A and B.
  
  
  CONCLUSIONS
  Stress examination under MRI control has advantages in the assessment of mechanical ankle instability. Additional diagnostic and clinically relevant information is obtained through direct imaging of the ligaments and assessment of additional parameters of ankle laxity (subtalar tilt, anterior calcaneus translation, medial talocalcaneal translation). The main advantages are objective imaging and measurement of abnormal looseness of the lower ankle joint and its direct simultaneous comparison with the upper ankle joint.
authors: Center for Musculoskeletal Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353 Berlin, Germany. christian.seebauer@gmx.net
authors: Christian J
authors: CJ
authors: Seebauer
authors: Hermann J
authors: HJ
authors: Bail
authors: Jens C
authors: JC
authors: Rump
authors: Bernd
authors: B
authors: Hamm
authors: Thula
authors: T
authors: Walter
authors: Ulf K M
authors: UK
authors: Teichgräber
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D004867:Equipment Design; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013314:Stress, Mechanical