Recent advances in diagnostic methodologies for tibiofibular syndesmosis injuries

This article focuses on the various diagnostic methods for tibiofibular syndesmosis injuries, as well as the advantages and disadvantages of each diagnostic method. The purpose of this study is to help clinicians make a more accurate diagnosis, so as to improve the prognosis of patients with tibiofibular syndesmosis injuries. Diagnostic methods for injury to the tibiofibular syndesmosis include physical examination, imaging techniques, arthroscopy, and novel kinematic assessment. Radiographic examination serves as the foundational diagnostic tool. CT imaging has significantly advanced in detecting minor injuries of the tibiofibular syndesmosis. MRI is currently recognized as the most sensitive and specific imaging modality, capable of accurately diagnosing ligament injuries. Ultrasonography is a valuable tool for demonstrating significant diagnostic utility in chronic tibiofibular syndesmosis injuries. Arthroscopy is the gold standard for diagnosing tibiofibular syndesmosis injuries. The modified stability test appears to be more aligned with current clinical diagnostic requirements. Its reliability and accuracy surpass those of traditional imaging techniques. Tibiofibular syndesmosis injuries, often resulting from high-energy trauma or rotational forces, represent a significant subset of ankle injuries that may occur either concurrently with or independently of ankle fractures. This condition can lead to ankle instability and secondary osteoarthritis, which severely impact patients' functional recovery and quality of life. Due to the anatomical complexity and varied injury patterns, accurately diagnosing tibiofibular syndesmosis injuries remains a clinical challenge. This review summarizes current diagnostic methods and research advancements in tibiofibular syndesmosis injuries, encompassing physical examination, imaging techniques, arthroscopy, and novel kinematic assessment, to assist clinicians in achieving more precise diagnoses and ultimately improving patient outcomes.