title: Structural abnormalities and persistent complaints after an ankle sprain are not associated: an observational case control study in primary care.
abstract: BACKGROUND
  Persistent complaints are very common after a lateral ankle sprain.
  
  
  OBJECTIVE
  To investigate possible associations between structural abnormalities on radiography and MRI, and persistent complaints after a lateral ankle sprain.
  
  
  METHODS
  Observational case control study on primary care patients in general practice.
  
  
  METHODS
  Patients were selected who had visited their GP with an ankle sprain 6-12 months before the study; all received a standardised questionnaire, underwent a physical examination, and radiography and MRI of the ankle. Patients with and without persistent complaints were compared regarding structural abnormalities found on radiography and MRI; analyses were adjusted for age, sex, and body mass index.
  
  
  RESULTS
  Of the 206 included patients, 98 had persistent complaints and 108 did not. No significant differences were found in structural abnormalities between patients with and without persistent complaints. In both groups, however, many structural abnormalities were found on radiography in the talocrural joint (47.2% osteophytes and 45.1% osteoarthritis) and the talonavicular joint (36.5% sclerosis). On MRI, a high prevalence was found of bone oedema (33.8%) and osteophytes (39.5) in the talocrural joint; osteophytes (54.4%), sclerosis (47.2%), and osteoarthritis (55.4%, Kellgren and Lawrence grade >1) in the talonavicular joint, as well as ligament damage (16.4%) in the anterior talofibular ligament.
  
  
  CONCLUSIONS
  The prevalence of structural abnormalities is high on radiography and MRI in patients presenting in general practice with a previous ankle sprain. There is no difference in structural abnormalities, however, between patients with and without persistent complaints. Using imaging only will not lead to diagnosis of the explicit reason for the persistent complaint.
authors.affiliation: Department of Radiology, Albert Schweitzer Hospital Dordrecht, the Netherlands.
authors.forename: John M
authors.initials: JM
authors.lastname: van Ochten
authors.affiliation: Department of Radiology, Albert Schweitzer Hospital Dordrecht, the Netherlands.
authors.forename: Marinka C E
authors.initials: MC
authors.lastname: Mos
authors.affiliation: Department of Radiology, Albert Schweitzer Hospital Dordrecht, the Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: van Putte-Katier
authors.affiliation: Department of Radiology, Erasmus MC Medical University Rotterdam, the Netherlands.
authors.forename: Edwin H G
authors.initials: EH
authors.lastname: Oei
authors.affiliation: Department of Radiology, Erasmus MC Medical University Rotterdam, the Netherlands.
authors.forename: Patrick J E
authors.initials: PJ
authors.lastname: Bindels
authors.affiliation: Department of Radiology, Erasmus MC Medical University Rotterdam, the Netherlands.
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.affiliation: Department of General Practice, Erasmus MC Medical University Rotterdam, the Netherlands.
authors.forename: Marienke
authors.initials: M
authors.lastname: van Middelkoop
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D017844:Lateral Ligament, Ankle / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010808:Physical Examination; D011320:Primary Health Care / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D013180:Sprains and Strains / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
keywords: abnormalities; ankle; general practice; imaging; sprain