Abstract
Introduction: Ankle sprains are amongst the most common traumatic soft-tissue injuries and are especially prevalent at all levels of sport, with lateral sprains accounting for 85% of all such injuries. The lateral ankle ligament complex consists of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). Stretching and in more severe forms - tearing of the ligaments can eventually lead to a sense of instability in the ankle and predispose the patient to receive frequent ankle sprains, a condition known as ankle instability. To determine the integrity of the stabilizing structures of the ankle joint different imaging methods are considered. The following report aims to describe stress X-rays, ultrasound and MRI as methods assisting in the diagnostics of ankle instability. Materials and methods: For a period of 2.5 years (August, 2013 - December, 2015) 948 of the patients who presented with inversion ankle trauma in the orthopedic department of St. Anna Hospital, Varna underwent testing for ankle injury. Out of the suspected for injury 92 underwent sonography of the ankle joint, 95 - stress X-ray and 26 - MRI. Results: The results of the currently presented methods show that they have different diagnostic value. The choice of an imaging method should be based on secondary criteria such as - probability of detecting associated injuries, influence over the health status, time consumption and cost of the examination. Conclusion: Diagnostics of ankle instability is no easy task for the clinician. Signs of damage to the ligaments, discovered after thorough physical examination require imaging methods to verify the injury. Based on the difference of stress X-rays, sonography and MRI in their complexity, cost and efficiency, they can be put in a diagnostic algorithm for approaching ankle instability.
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