Dynamic Ultrasound in Evaluation of Tendo-ligamentous Ankle Injury

Comparative Study Between Dynamic Ultrasound and MRI in Evaluation of Tendino-ligamentous Injuries Around the Ankle Joint

Several imaging modalities, such as computed tomography, magnetic resonance imaging, and ultrasound (US) can be used to evaluate the ankle. However, US has several benefits for the evaluation of the tendons and ligaments of the ankle, such as its suitability to be integrated with a dynamic assessment and a stress test, its ability to provide real-time analysis, its avoidance of the risk of radiation exposure, and its cost-effectiveness. US is especially powerful when used to evaluate a tear, subluxation, or dislocation in a dynamic examination and when performing a comparison with the contralateral extremity. Dynamic imaging with muscle contraction or passive movement is often helpful. Additionally, Doppler imaging may be used to distinguish small intrasubstance tears from blood vessels that can occur in a tendinopathic tendon.

Study Overview

• Status: Unknown
• Conditions: Tendinoligamentous Injury of the Ankle

Detailed Description

Ankle injuries account for approximately 14% of sports-related orthopedic emergency visits. Various pathological conditions can affect the ankle, including trauma, overuse disorders, and inflammatory conditions.

Several imaging modalities, such as computed tomography, magnetic resonance imaging, and ultrasound (US) can be used to evaluate the ankle. However, US has several benefits for the evaluation of the tendons and ligaments of the ankle, such as its suitability to be integrated with a dynamic assessment and a stress test, its ability to provide real-time analysis, its avoidance of the risk of radiation exposure, and its cost-effectiveness. US is especially powerful when used to evaluate a tear, subluxation, or dislocation in a dynamic examination and when performing a comparison with the contralateral extremity. Dynamic imaging with muscle contraction or passive movement is often helpful. Additionally, Doppler imaging may be used to distinguish small intrasubstance tears from blood vessels that can occur in a tendinopathic tendon.

Approximately 85%of them are due to inversion forces and, therefore, involve the lateral collateral ligamentous complex. A Grade I sprain is a mild injury limited to microtears and stretching of the ligaments. Grade II sprains are partial macroscopic tears and in Grade III sprains the ligament has ruptured completely. There is general agreement that the overwhelming majority of Grade I and II sprains heal uneventfully with conservative care. Treatment of Grade III sprains is more controversial: some practitioners prefer operative repair, at least for high-performance athletes and others prefer a regimen of casting and physical therapy, which is the case in our institution. The proper role of imaging in the diagnosis of ankle sprains includes first of all conventional radiographs to ensure a fracture is not overlooked. Ultrasound is will be used to evaluate disorders of the musculoskeletal system, and because of their size and superficial location the ankle tendons can be well evaluated

• Study Type: Observational
• Enrollment (Anticipated): 30

Contacts and Locations

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 15 years to 60 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

no gender based Age 15-60 -y-old Complaining from unilateral ankle pain or instability

Description

Inclusion Criteria:

• patients complaining of unilateral ankle joint pain (acute or chronic).

Exclusion Criteria:

• previous ankle surgery, interventional Intra-articular procedures (previous arthroscope, injections),
• Systemic inflammatory disorders (collagen diseases),
• Diagnosed osseous lesions.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Cases; Patients complaining of ankle pain, swelling or dysfunction underwent ultrasound examination and then MRI as a reference to compare the diagnostic accuracy of ultrasonography in the assessment of tendino-ligamentous injuries around the ankle joint

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of ankle tendi-ligamentous injury by dynamic ultrasound and MRI	Approximately 85%of anke tendo-ligamentous injuries are due to inversion forces and, therefore involve the lateral collateral ligamentous complex.; Grade I sprain is a mild injury limited to microtears and stretching of the ligaments.; Grade II sprains are partial macroscopic tears; Grade III sprains the ligament has ruptured completely.	1 month

Collaborators and Investigators

• Sponsor: Assiut University

Publications and helpful links

General Publications

• Bianchi S, Martinoli C, Gaignot C, De Gautard R, Meyer JM. Ultrasound of the ankle: anatomy of the tendons, bursae, and ligaments. Semin Musculoskelet Radiol. 2005 Sep;9(3):243-59. doi: 10.1055/s-2005-921943.
• Khoury V, Guillin R, Dhanju J, Cardinal E. Ultrasound of ankle and foot: overuse and sports injuries. Semin Musculoskelet Radiol. 2007 Jun;11(2):149-61. doi: 10.1055/s-2007-1001880.

Study record dates

Study Major Dates

• Study Start (Anticipated): September 1, 2018
• Primary Completion (Anticipated): August 1, 2020
• Study Completion (Anticipated): October 1, 2020

Study Registration Dates

• First Submitted: August 2, 2018
• First Submitted That Met QC Criteria: August 7, 2018
• First Posted (Actual): August 8, 2018

Study Record Updates

• Last Update Posted (Actual): August 8, 2018
• Last Update Submitted That Met QC Criteria: August 7, 2018
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Keywords: musculoskeletal ultrasound; mri; tendinopathy
• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: Dynamic ankle ultrasound

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No