الفهرس 
ANATOMY OF THE ANKLE JOINTOnly 14 pages are availabe for public view
 |  | from | 297 |  |  |
| | | from | 297 | | |
Abstract
Ankle pain is a common complain in orthopedic practice. The aetiology of ankle pain includes various pathologies such as tendon and ligament injuries, joint disorders, osseous lesions, and soft tissue pathologies.
The aim of this study is to highlight the role of ultrasonography in assessment of musculoskeletal disorders of the ankle joint especially those related to ankle tendons and ligaments.
This study included 60 patients presented with ankle pain. Comparative ultrasonographic examination of both ankles was performed in all cases and the results were correlated with other imaging modalities including plain radiography, CT and / or MRI. We found that;
For ankle tendons:
Achilles tendon is the most commonly injured ankle tendon followed by tibialis posterior tendon in the medial ankle compartment while those of the anterior compartment were the least encountered ones. Tendinosis was the most encountered tendon pathology followed by tenosynovitis. Compared to MRI, ultrasonography, in our study, yielded 100% sensitivity and 97.6 % specificity for tendinosis, 75 % sensitivity and 100 % specificity for partial tear, 100% sensitivity and specificity for complete tear, and 75 % sensitivity and 100 % specificity for tenosynovitis.
For ankle ligaments:
Approximately 94.8% of ligamentous lesions were due to inversion ankle sprain that involved the lateral collateral ligament complex. The ATFL was the most frequently torn ligament (68 %) and in most cases it was the isolated injury. This was followed by CFL injury (27.5 %) that accompanied ATFL injury in its all cases. PTFL could not be assessed by ultrasonography due to its deep location. Deltoid ligament, in the medial ankle compartment, was the least injured ligament (4.5 %). Compared to MRI, ultrasonography yielded 100 % sensitivity and 98 % specificity for stretched ATFL or CFL, 91.3 % sensitivity and 93.1 % specificity for partially torn ATFL, 77.7 % sensitivity and 97.6 % specificity for partially torn CFL, 66.6 % sensitivity and 97.8 % specificity for completely torn ATFL, and 50 % sensitivity and 98 % specificity for completely torn CFL.
Ultrasonography was 76 % sensitive in detecting ankle joint effusion relative to MRI with 100 % specificity and 90.3 % accuracy. The missed cases of ankle effusion at ultrasound were all minimal in amount and of questionable clinical importance. Ultrasound was also valuable in diagnosing cases of bursitis.
Ultrasound was efficient in evaluating soft tissue pathologies such as lipomas and ganglion cysts.
Ultrasound could identify avulsion fractures which are not always recognizable on plain x-ray films. However, evaluation of other fractures is best performed using plain radiography and CT scan.