title: Deltoid Ligament and Tibiofibular Syndesmosis Injury in Chronic Lateral Ankle Instability: Magnetic Resonance Imaging Evaluation at 3T and Comparison with Arthroscopy.
abstract: OBJECTIVE
  To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI).
  
  
  METHODS
  Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard.
  
  
  RESULTS
  On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively.
  
  
  CONCLUSIONS
  Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential.
authors.affiliation: Department of Radiology, Eulji Hospital, Eulji University, Seoul 01830, Korea.
authors.forename: Ka-Young
authors.initials: KY
authors.lastname: Chun
authors.affiliation: Department of Radiology, Eulji Hospital, Eulji University, Seoul 01830, Korea.
authors.forename: Yun Sun
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Radiology, Eulji Hospital, Eulji University, Seoul 01830, Korea.
authors.forename: Seok Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Eulji Hospital, Eulji University, Seoul 01830, Korea.
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Eulji Hospital, Eulji University, Seoul 01830, Korea.
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Young
authors.affiliation: Department of Radiology, Eulji Hospital, Eulji University, Seoul 01830, Korea.
authors.forename: Min-Sun
authors.initials: MS
authors.lastname: Jeong
authors.affiliation: Department of Radiology, Eulji Hospital, Eulji University, Seoul 01830, Korea.
authors.forename: Dae-Jung
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D001182:Arthroscopy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D055815:Young Adult
keywords: 3T; Chronic ankle instability; Deltoid ligament; Lateral collateral ligament; Magnetic resonance imaging; Syndesmosis