[Acute ankle injuries].

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Lateral collateral ankle ligament trauma diagnosis relies on patient history, clinical examination, and stress tests.
• The utility of stress radiography for acute ankle sprains is debated, with no consensus on definitive cut-off values for ligament rupture.
• Magnetic Resonance Imaging (MRI) is currently underutilized for this indication despite its potential for detailed visualization.

Purpose of the Study:

• To evaluate the diagnostic imaging modalities for lateral collateral ankle ligament trauma.
• To discuss the role of stress radiography and MRI in diagnosing acute ankle sprains.
• To highlight MRI as a valuable second-step diagnostic tool when initial radiographs are non-diagnostic.

Main Methods:

• Review of current diagnostic practices for lateral collateral ankle ligament injuries.
• Analysis of the role of clinical examination, stress tests, and radiography.
• Discussion of the capabilities of MRI and Computed Tomography (CT) in ankle injury assessment.

Main Results:

• Plain radiographs are the primary imaging modality for ankle injuries, providing definitive answers in most cases.
• Stress radiography's role in acute ankle sprains lacks consensus regarding interpretation and cut-off values.
• MRI is effective for visualizing injured ligaments and is crucial for diagnosing occult fractures, avascular necrosis, and tendon injuries when ultrasound is inconclusive.

Conclusions:

• Clinical assessment remains the cornerstone for diagnosing ankle ligament trauma.
• Radiography is essential, but MRI serves as a critical second-line investigation for complex or indeterminate ankle injuries.
• Optimizing MRI protocols could enhance its utility in evaluating lateral collateral ankle ligament injuries.