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[Indication for radiological examination in acute ankle distorsion]
C W Henriksen1, M S Larsen, B Fiirgaard
1Ortopaedkirurgisk afdeling, Vejle Sygehus.
Ugeskrift for Laeger
|April 1, 1996
Summary
A thorough physical examination can reduce the need for ankle trauma X-rays. Key predictors for significant injury include swelling, lateral malleolus tenderness, and inability to bear weight.
Area of Science:
- Orthopedics
- Radiology
- Emergency Medicine
Background:
- Ankle inversion injuries are frequent in emergency departments.
- These injuries place a significant burden on radiological services.
- Clinical assessment may reduce unnecessary radiographic imaging.
Purpose of the Study:
- To evaluate if a detailed physical examination can decrease the number of radiographs ordered for acute ankle trauma.
- To identify the most reliable clinical predictors of significant ankle injury.
Main Methods:
- A prospective study involving 201 patients with acute ankle trauma.
- All patients underwent both clinical assessment and radiographic examination.
- Sensitivity and specificity of clinical signs were calculated.
Main Results:
- Swelling, focal bony tenderness on the lateral malleolus, and inability to bear weight were significant predictors of injury, especially when present together.
- The bimalleolar distance ratio was not found to be a reliable predictor in this study.
Conclusions:
- A comprehensive clinical examination is effective in identifying patients with acute ankle trauma who require radiographic imaging.
- Specific clinical signs, including swelling, lateral malleolar tenderness, and weight-bearing ability, are crucial for decision-making.
- Routine radiography may be reduced by relying on clinical assessment for ankle trauma.