Document Detail

Impingement syndrome of the ankle following supination external rotation trauma: MR imaging findings with arthroscopic correlation.
MedLine Citation:
PMID:  12764653     Owner:  NLM     Status:  MEDLINE    
Our objective was to identify MR imaging findings in patients with syndesmotic soft tissue impingement of the ankle and to investigate the reliability of these imaging characteristics to predict syndesmotic soft tissue impingement syndromes of the ankle. Twenty-one ankles with chronic pain ultimately proven to have anterior soft tissue impingement syndrome were examined by MR imaging during January 1996 to June 2001. The MR imaging protocol included sagittal and coronal short tau inversion recovery (STIR), sagittal T1-weighted spin echo, axial and coronal proton-density, and T2-weighted spin-echo sequences. Nineteen ankles that underwent MR imaging during the same period of time and that had arthroscopically proven diagnosis different than impingement syndrome served as a control group. Fibrovascular scar formations distinct from the syndesmotic ligaments possibly related to syndesmotic soft tissue impingement were recorded. Arthroscopy was performed subsequently in all patients and was considered the gold standard. The statistical analysis revealed an overall frequency of scarred syndesmotic ligaments of 70% in the group with ankle impingement. Fibrovascular scar formations distinct from the syndesmotic ligaments presented with low signal intensity on T1-weighted images and remained low to intermediate in signal intensity on T2-weighted MR imaging. Compared with arthroscopy, MR imaging revealed a sensitivity of 89%, a specificity of 100%, and a diagnostic accuracy of 93% for scarred syndesmotic ligaments. The frequency of scar formation distinct from the syndesmotic ligaments in patients with impingement syndrome of the ankle was not statistically significantly higher than in the control group. In contrast to that, anterior tibial osteophytes and talar osteophytes were statistically significantly higher in the group with anterior impingement than in the control group. Conventional MR imaging was found to be insensitive for the diagnosis of syndesmotic soft tissue impingement of the ankle. Fibrovascular scar tissue distinct from syndesmotic ligaments is suggestive for the diagnosis of soft tissue impingement, but the reliability of these findings is still questionable.
Gottfried J Schaffler; Phillip F J Tirman; David W Stoller; Harry K Genant; Cecar Ceballos; Michael F Dillingham
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Publication Detail:
Type:  Journal Article     Date:  2002-10-12
Journal Detail:
Title:  European radiology     Volume:  13     ISSN:  0938-7994     ISO Abbreviation:  Eur Radiol     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-05-23     Completed Date:  2003-10-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1357-62     Citation Subset:  IM    
Department of Radiology, University of California San Francisco, 350 Parnassus Avenue, Suite 150, San Francisco, CA 94117, USA.
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MeSH Terms
Ankle Injuries / complications*
Ankle Joint
Athletic Injuries / complications*
Case-Control Studies
Ligaments, Articular / injuries*
Magnetic Resonance Imaging*
Soft Tissue Injuries / etiology,  pathology*
Sprains and Strains / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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