Intrasound vibration testing in acute ankle injuries

Area of Science:

• Orthopedics
• Diagnostic Imaging
• Emergency Medicine

Background:

• Acute ankle injuries are common in emergency departments.
• Radiography is the standard diagnostic tool for suspected ankle fractures.
• Novel diagnostic methods are being explored to improve accuracy and efficiency.

Purpose of the Study:

• To evaluate the diagnostic accuracy of intrasound vibration testing (IVT) compared to plain radiography for acute ankle fractures.
• To determine the sensitivity, specificity, and predictive values of IVT in diagnosing ankle fractures.

Main Methods:

• A group-sequential, nonrandomized, double-blind, observational study.
• Included patients aged 10+ with acute ankle injuries undergoing radiography.
• IVT applied to malleoli; positive if pain caused withdrawal. Excluded injuries >24h, inadequate data, or positive IVT on uninjured ankle.

Main Results:

• Of 97 analyzed patients, 13 had fractures (9 lateral malleolar, 1 medial malleolar, 1 bimalleolar, 2 talar).
• IVT detected only 5 of 13 fractures (sensitivity 39%). Specificity was 83%.
• Positive predictive value was 26%; negative predictive value was 90%. Overall accuracy was 77%.

Conclusions:

• Intrasound vibration testing demonstrates low sensitivity and poor positive predictive value for diagnosing acute ankle fractures.
• IVT is not a reliable standalone diagnostic tool for acute ankle fractures.
• Further research is needed to explore the utility of IVT in specific patient populations or as an adjunct to radiography.