J Korean Orthop Assoc.
2023 Aug;58(4):331-340. 10.4055/jkoa.2023.58.4.331 .
Use of Ultrasonography for Differential Diagnosis of Acute Ankle Injury
- Affiliations
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- 1Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea
- KMID: 2545293
- DOI: http://doi.org/10.4055/jkoa.2023.58.4.331
Abstract
- Acute ankle injuries are the most common sports injuries. Ankle ligament injury occurs in 85% of acute ankle injuries, of which anterior talofibular ligament injury is the most common, but it can be accompanied by deltoid ligament or anterior inferior tibiofibular ligament injuries. In addition to ligament injury, peroneus tendon rupture or dislocation, adjacent area fracture such as calcaneal anterior process fracture and sensory nerve injury around ankle may occur. Furthermore underlying ankle diseases, such as accessory navicular syndrome, os subfibulare and tarsal coalition, may be exacerbated by acute ankle injury, so the cause of pain should be accurately identified. Ultrasonography is extremely useful for differential diagnosis of acute ankle injury and can be performed quickly in outpatient clinics or emergency room setting. In addition, dynamic test such as stress test can identify instability and easily observe and diagnose the degree of damage. It can also be useful for differential diagnosis in ligament injury, possible occult fracture, common ossicle, nerve injury, and tendon injury. However, ultrasonography is limited when differentiating other disease entities such as tarsal coalition, sinus tarsi syndrome and osteochondral lesion that are located deep in the joint, thus additional test modalities such as magnetic resonance and nuclear medicine imaging may be required.
