52 The association between factors from anamnesis and physical examination and early signs of osteoarthritis in patients with persistent symptoms after an ankle sprain: a cross-sectional study in general practice

Abstract

Background Structural abnormalities on MRI are frequently found after a lateral ankle sprain. Objective To determine the possible associations between patient’s history, physical examination and early signs of osteoarthritis in patients with a previous ankle sprain. Design Cross-sectional. Setting General practice. Patients Ninety-eight patients who consulted their general practitioner, 6 to 12 months prior to inclusion, with a lateral ankle sprain and reported persistent complaints were selected for the present study. Of these, 94 patients underwent a physical examination and MRI and were included for the present study. Assessment of risk factors A standardised questionnaire and a standardised physical examination, including the assessment of swelling, hind foot position, range of motion, anterior drawer test and talar tilt test, were applied. All patients underwent a MRI. Main outcome measurements On MRI the presence of osteochondral lesions, cartilage loss, bone oedema and any sign of osteoarthritis were scored by a radiologist. Univariate and multivariate analyses were used to test the association between patients’ history and anamnesis and early signs of osteoarthritis as seen on MRI. Results Cartilage loss in the talonavicular joint (17.3%); osteochondral lesions (6.1%) and bone oedema in the talocrural joint (25.%) and early signs of osteoarthritis (48%) were found on MRI. Multivariable analyses showed that pain at the end stage of dorsiflexion or plantar flexion was associated with cartilage loss in the talonavicular joint (with OR 0.56; 95% CI 0.13–2.43). No other significant associations were found. Conclusions We found only one significant association between patient related factors from history taking and physical examination and early signs of osteoarthritis in patients with persistent complaints after a lateral ankle sprain. More studies with enough power are needed to investigate the association between potential predictors and the detection of early osteoarthritis after a lateral ankle sprain.