MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-...

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Bibliographic Details
Published in:European journal of radiology Vol. 58; no. 3; pp. 450 - 460
Main Authors: Haller, Jörg, Bernt, Reinhard, Seeger, Thomas, Weissenbäck, Alexander, Tüchler, Heinrich, Resnick, Donald
Format: Journal Article
Language:English
Published: Shannon Elsevier Ireland Ltd 01-06-2006
Elsevier Science
Subjects:
Adolescent
Adult
Aged
Ankle joint
Ankle Joint - pathology
Arthroscopy - methods
Biological and medical sciences
Female
Humans
Impingement syndrome
Indirect MR-arthrography
Investigative techniques, diagnostic techniques (general aspects)
Joint Diseases - diagnosis
Ligaments, Articular - pathology
Magnetic Resonance Imaging - methods
Male
Medical sciences
Middle Aged
MR-imaging
Observer Variation
Osteoarticular system. Muscles
Prospective Studies
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Reproducibility of Results
Sensitivity and Specificity
Syndrome
Talus - pathology
Tendons - pathology
Tibia - pathology
Impingement syndrome
Indirect MR-arthrography
Ankle joint
MR-imaging
Sensitivity
Specificity
Radiodiagnosis
Arthrography
Medical imagery
Nuclear magnetic resonance imaging
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Summary:To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91–0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50–0.24). MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome.
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ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2006.03.008