Lateral Ligament Instability: Review of Pathology and Diagnosis

Ankle sprains are a common injury that can lead to chronic lateral ankle instability resulting in pain, poor function, and decreased quality of life. The purpose of this review is to present information regarding injury mechanisms to the lateral ligaments of the ankle and the necessary steps to appropriately diagnose lateral ligament instability.

The literature demonstrates that history and physical examination is often a reliable method for diagnosis of lateral ankle instability. In addition, imaging modalities are often used as adjuncts for diagnosis, especially when physical exam findings are equivocal. In summary, chronic lateral ligament instability of the ankle occurs secondary to failure of the lateral ligamentous complex. A focused physical examination to evaluate the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament is necessary for diagnosis. Imaging modalities including plain radiographs, stress radiographs, and MRI are helpful for definitive diagnosis and to rule out other pathology.