Conventional MRI Versus MR Arthrography in Evaluation of Ankle Impingement Syndromes and Intra Articular Pathologies.

July 29, 2022 updated by: Kawsar Abdel Halim Mohamed, Assiut University

Conventional Magnetic Resonance Imaging Versus Magnetic Resonance Arthrography in Evaluation of Ankle Impingement Syndromes and Intra Articular Pathologies.

Chronic ankle pain is a common clinical problem with a wide differential diagnosis. Soft-tissue and osseous impingement syndromes are now increasingly recognized as a significant cause of chronic ankle pain. Ankle impingement syndromes are defined as pathologic conditions resulting in chronic, painful restriction to movement at the tibiotalar articulation secondary to soft-tissue or osseous abnormalities. Ankle impingement is classified according to its anatomic relationship to the tibiotalar joint as anterolateral, anterior, anteromedial, posteromedial, or posterior impingement.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The anterolateral impingement syndrome is caused by obstruction of the so-called anterolateral gutter (ALG) or recess secondary to an inversion injury resulting in disruption of the syndesmotic and/or lateral collateral ligaments and capsule.

In anterior impingement,Arthroscopic evaluations suggest direct microtrauma to the talus and tibia as the aetiology. The natural course of this microtraumas to form osseous spurs.

In anteromedial impingement,The mechanism is not well understood but is likely a rare complication of a supination (inversion) injury rather than a pronation (eversion) injury as initially hypothesized.During the acute injury, there is damage to the anterior tibiotalar ligament, which subsequently thickens. In addition toligament thickening, osteophytes, synovitis and fractures have been described as other possible causative factors.

In posteromedial impingement, the common precipitating injury for posteromedial ankle impingement is a plantar flexion, inversion and internal rotation trauma. This can lead to damage to the PTTL and associated synovitis.

The majority of the posterior impingement syndromes are related to the posterior talus.The secondary ossification centre of the posterolateral talus forms around 8-13 years of age and then subsequently fuses within 1 year of that. Occasionally (approximately 7%), there may be non-fusion with a resultant ostrigonum.

Conventional MR imaging can accurately detect and localize osteophytes and associated lesions. In addition, MR imaging provides an easy evaluation of any articular cartilage changes, ligamentous injury, and occult bony contusions.

Direct magnetic resonance (MR) arthrography extends the capabilities of conventional MR imaging and utilizes the natural advantages gained from joint effusion. Contrast solution distends the joint capsule, outlines intra articular structures,and leaks into abnormalities.It can detect cartilage damage, intra articular loose bodies and osteochondral talar lesions.

Study Type

Observational

Enrollment (Anticipated)

40

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients in different age groups and both sex clinically presented with chronic ankle pain.

Description

Inclusion Criteria:

  • patients in different age groups and both sex referred from orthopedic outpatient clinic with chronic ankle pain and suspected clinically to have impingement syndrome.

Exclusion Criteria:

  1. Inflammatory arthritis of ankle joint, infection in ankle joint, neoplasm around ankle joint.
  2. Patients with contraindications for MRI, e.g. an implanted magnetic device, pacemakers or claustrophobia.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Case-Only
  • Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Ligamentous disruption and thickening.
Time Frame: base line
to detect the ligamentous disruption and thickening by conventional MRI and direct MR arthrography of the ankle joint.
base line
Capsular thickening and synovitis.
Time Frame: baseline
to detect the capsular thickening and synovitis by conventional MRI and direct MR arthrography of the ankle joint.
baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
correlate the findings of conventional MRI and MR Arthrography of the ankle with clinical and operative findings.
Time Frame: baseline
to correlate the ligamentous disruption and thickening, capsular thickening and synovitis with clinical and operative findings (arthroscopy or open surgery).
baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Principal Investigator: Kawsar Mohamed, Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 10, 2020

Primary Completion (Anticipated)

September 30, 2022

Study Completion (Anticipated)

December 30, 2022

Study Registration Dates

First Submitted

February 23, 2019

First Submitted That Met QC Criteria

March 1, 2019

First Posted (Actual)

March 4, 2019

Study Record Updates

Last Update Posted (Actual)

August 1, 2022

Last Update Submitted That Met QC Criteria

July 29, 2022

Last Verified

July 1, 2021

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • MRAAIS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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