MRI Utilization in Acute Ankle Inversion Injuries: Indications and Optimal Timing

Timing Of MRI in Acute Lateral Ankle Sprain: Impact On Diagnostic Findings And Clinical Interpretation – A Retrospective Observational Cohort Study

Patients with acute inversion-type ankle sprain were divided into three equal groups based on MRI timing: hyperacute (0–7 days), subacute (8–21 days), and late (>21 days).

MRI-Based Retrospective Analysis of Knee Joint Injuries: Patterns and Prevalence

MRI provides a detailed evaluation of knee injuries, aiding diagnosis and management, and MRI detection of associated abnormalities helps guide treatment and improve patient outcomes.

A head-to-head comparison of high-frequency ultrasound and magnetic resonance imaging for preoperative assessment of ATFL tears and concomitant CFL injuries

HFUS demonstrates better diagnostic performance for preoperative grading of ATFL tear severity, whereas MRI shows moderate diagnostic capability in detecting concomitant CFL injuries in the setting of combined lateral ankle ligament trauma.

Reconsidering uniform treatment: magnetic resonance imaging-based insights into the multiform pathophysiology of sprained ankles.

INTRODUCTION Ankle sprains are among the most common musculoskeletal injuries, yet their clinical complexity is often underestimated. The relationship between ankle sprains and bone bruises in both the ankle joint and midfoot remains underexplored. At our institution, patients with moderate to severe ankle sprains routinely undergo magnetic resonance imaging (MRI) and receive conservative treatment with a short leg posterior cast splint. This study specifically focused on bone involvement assessed by MRI, rather than soft tissue or functional parameters. METHODS We retrospectively reviewed MRI scans of 70 patients with acute moderate (Grade 2) to severe (Grade 3) ankle sprains who presented consecutively between November 2014 and December 2019. Patients with mild sprains (Grade 1) were excluded. Bone bruises were assessed, and all patients were treated with a short leg posterior cast splint extending from the lower leg to the forefoot. Crutches were prescribed when pain persisted during weight-bearing after splint application. Multivariable logistic regression analysis was performed to evaluate the associations between MRI-detected bone bruises and crutch use following fixation. RESULTS The fixation period, available in 63 patients, ranged from 8 to 72 days (mean: 29.5 days). Walking pain requiring crutches, used as a proxy indicator of persistent weight-bearing pain rather than a validated clinical outcome, was observed in 32 /70 (45.7%) of patients. All patients experienced resolution of ankle joint pain following treatment. MRI revealed bone bruises in the ankle and midfoot in 57/70 (81.4%) of cases. Midfoot involvement, including the tarsal bones and Chopart joint, was present in 24/70 (34.3%) of cases. The talus was the most frequently affected bone 42/70 (60.0%), followed by the tibia 31/70 (44.3%), tarsal bones 18/70 (25.7%), and calcaneus 15/70 (21.4%). Bone bruises on the talocrural joint surface of the talus were significantly associated with crutch use after fixation (P = 0.041). Multivariable logistic regression analysis identified both younger age (odds ratio [OR] 0.957, 95% confidence Interval [CI] 0.930-0.985, P = 0.003) and bone bruises on the talocrural joint surface of the talus (OR 4.012, 95% CI 1.174-13.713, P = 0.027) as independent predictors of crutch use after fixation. All patients reported resolution of ankle joint pain by the final follow-up, with no persistent or recurrent symptoms documented during the observation period. CONCLUSION Bone bruises in the ankle and midfoot are frequently associated with moderate to severe ankle sprains. MRI findings indicate a multifaceted pathophysiology, underscoring the importance of individualized treatment strategies. In cases where bone bruises are present on the talocrural joint surface, midfoot immobilization and a temporary period of non-weight-bearing may be appropriate considerations.

The Diagnostic Role of Examination Under Anaesthesia and MRI in Chronic Symptomatic Lateral Ankle Ligament Instability.

BACKGROUND Chronic lateral ankle instability commonly develops following traumatic rupture or pathological laxity of the lateral ankle ligament complex. Although magnetic resonance imaging (MRI) is effective in identifying complete ligament tears, it may be less reliable in detecting functional ligament incompetence due to elongation or laxity. PURPOSE OF THE STUDY This study evaluates whether examination under anesthesia (EUA) provides superior diagnostic accuracy compared to MRI in patients with chronic lateral ankle instability. STUDY DESIGN A prospective case analysis was performed on 49 symptomatic patients who underwent lateral ligament reconstruction. All patients underwent preoperative MRI and EUA. METHODS EUA was conducted under general anaesthesia using image-intensifier-guided anterior drawer and talar tilt stress tests. MRI scans were independently assessed by two experienced musculoskeletal radiologists. MRI findings were compared with both EUA and intraoperative findings. RESULTS EUA demonstrated ankle instability in 48 out of 49 patients, with positive anterior drawer and talar tilt tests. When compared with intraoperative findings, MRI demonstrated a sensitivity of 59.2%. In comparison, the EUA showed a sensitivity of 98%. Intraoperative findings included complete ligament rupture in 17 patients (34.7%), ligament laxity in 18 (36.7%), elongated lateral ligament complex in 13 (26.5%), and partial rupture in 1 patient (2.0%). CONCLUSIONS EUA, in conjunction with clinical symptoms, appears more reliable than MRI in diagnosing chronic lateral ankle instability and should be considered a key diagnostic tool in its management.

No e ff ect of dislocation status at arrival in emergency department on outcome of knee joint dislocations