AI Article Synopsis
- The study evaluates the effectiveness of point-of-care ultrasound in diagnosing acute lateral ankle ligament injuries compared to the gold standard, magnetic resonance imaging (MRI).
- It includes a meta-analysis of eight studies with 434 patients, revealing high sensitivity (97% for ATFL and 81% for CFL) and specificity (93% for ATFL and 92% for CFL) for ultrasound diagnostics.
- The findings suggest that ultrasound is a reliable and accessible option for initial diagnosis of these injuries, which is especially beneficial given the limitations of MRI in terms of availability and time.
Article Abstract
Background: The gold standard diagnostic method for acute lateral ankle ligament sprain is magnetic resonance imaging (MRI). However, it is hardly accessible and is time-consuming. Therefore, additional diagnostic methods are warranted. Point-of-care ultrasound, on the other hand, is inexpensive, widely available, time-efficient testing method.
Purpose: Therefore, the aim of this meta-analysis is to determine the diagnostic accuracy of ultrasound for acute ankle ligament injuries compared to MRI.
Methods: In our systematic review and meta-analysis, we followed the recommendations of the Cochrane Handbook. We searched the following databases from inception to March 31, 2022: Medline (PubMed), EMBASE, and Cochrane Library. Eligible studies investigated the diagnostic accuracy of US compared to MRI for diagnosing acute lateral ankle ligament injuries. Finally, we calculated pooled sensitivity and specificity with a 95 % confidence interval (CI).
Results: Eight studies met our eligibility criteria, involving 434 patients. For anterior tibiofibular ligament (ATFL) injury, the summary sensitivity and specificity were Se = 0.97 (CI: 0.89-0.99) and Sp = 0.93 (CI: 0.84-0.97). For calcaneofibular ligament (CFL) injury, the summary sensitivity and specificity were Se.: Se = 0.81 (CI: 0.58-0.93) and Sp = 0.92 [0,81;0,97]. In addition, subgroup analysis based on US performed by different types of investigators was comparable between each other (radiologist group Se = 0.98, CI: 0.24-1, and Sp = 0.91, CI: 0.74-0.97, and the orthopedic/ emergency department group Se = 0.96, CI: 0-1, and Sp = 0.97, CI: 0-1).
Conclusion: Ultrasound showed high diagnostic accuracy for acute lateral ankle ligament injury, irrespective of the investigator. Therefore, based on the current available data, it could be used in primary diagnostics of acute lateral ankle ligament injury.
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| http://dx.doi.org/10.1016/j.injury.2024.111730 | DOI Listing |
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