Correlation of stress radiographs to injuries associated with lateral ankle instability.

Background: Stress radiographs have demonstrated superior efficacy in the evaluation of ankle instability.

Aim: To determine if there is a degree of instability evidenced by stress radiographs that is associated with pathology concomitant with ankle ligamentous instability.

Methods: A retrospective review of 87 consecutive patients aged 18-74 who had stress radiographs performed at a single institution between 2014 and 2020 was performed. These manual radiographic stress views were then correlated with magnetic resonance imaging and operative findings.

Results: A statistically significant association was determined for the mean and median stress radiographic values and the presence of peroneal pathology ( = 0.008 for tendonitis and = 0.020 for peroneal tendon tears). A significant inverse relationship was found between the presence of an osteochondral defect and increasing degrees of instability ( = 0.043).

Conclusion: Although valuable in the clinical evaluation of ankle instability, stress radiographs are not an independent predictor of conditions associated with ankle instability.