Abstract
Background: The studies about injury to the anterior talo-fibular ligament (ATFL) are focused mainly on chronic symptoms and chronic instability, and the literature about the accuracy of magnetic resonance imaging (MRI) in acute injuries is quite lacking. Methods: This systematic review with meta-analysis analyzes the diagnostic accuracy of MRI on acute ATFL injury. Relative studies were retrieved after searching three databases (MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. The quality of the included articles was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data were extracted to calculate pooled sensitivity and specificity of MRI. Results: Seven studies met our inclusion and exclusion criteria. For MRI, the pooled sensitivities and specificity in diagnosing acute ATFL injury were respectively 1.0 (95% CI: 0.58–1) and 0.9 (95% CI: 0.79–0.96). Pooled LR+ and LR− were respectively 10.4 (95% CI: 4.6–23) and 0 (95% CI: 0–0.82). Conclusion: This systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of acute ATFL injury. Our results demonstrated that MRI shows high diagnostic accuracy in the diagnosis of acute ATFL lesions. These results suggest that routine MRI in the case of suspected ATFL acute injury may be clinically useful, although this is not done in clinical practice due probably to high cost.
Highlights
Ankle sprains are among the most common injuries during sport events, accounting for up to 40% of all athletic injuries [1]
The following criteria were used to include qualified studies: (1) cohort-type or crosssectional studies; (2) evaluated magnetic resonance imaging (MRI) for the diagnosis of acute anterior talo-fibular ligament (ATFL), with MRI performed within three months of the injury; (3) compared imaging results with arthroscopic or surgical findings as reference standards; and (4) reported data that enabled the calculation of the respective numbers of true positive (TP), true negative (TN), false positive (FP), and false negative (FN)
This systematic review with meta-analysis studied the accuracy of MRI imaging for the diagnosis of acute ATFL injury, with the aim of assessing the clinical usefulness of an early diagnosis
Summary
Ankle sprains are among the most common injuries during sport events, accounting for up to 40% of all athletic injuries [1]. The ATFL has the main role in resisting inversion in plantarflexion and anterolateral translation of the talus in the mortise Considering both isolated and combined ligament injury, the ATFL can be damaged in up to 90% of major ankle injuries, compared to the CFL in 50–75% and PTFL in only 10% [2,3,4]. Methods: This systematic review with meta-analysis analyzes the diagnostic accuracy of MRI on acute ATFL injury. For MRI, the pooled sensitivities and specificity in diagnosing acute ATFL injury were respectively 1.0 (95% CI: 0.58–1) and 0.9 (95% CI: 0.79–0.96). Our results demonstrated that MRI shows high diagnostic accuracy in the diagnosis of acute ATFL lesions. These results suggest that routine MRI in the case of suspected ATFL acute injury may be clinically useful, this is not done in clinical practice due probably to high cost
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