by
Barbara Kram, Editor | January 16, 2006
"In syndesmotic tear, the biggest ligament that holds the tibia and fibula together is injured," Dr. Towers explained. "The fibula can move away from the tibia, and the cylindrical groove which forms the ankle can widen under load. The problem is that routine x-rays may not show it, because it's not grossly misaligned. It's during athletic activity when the injury becomes most apparent."
Left undiagnosed, high ankle sprain can impede an athlete's performance and lead to arthritis. "The treatment for high ankle sprain is different and generally longer than for a typical ankle sprain," Dr. Towers said. "If it is not recognized, and you send somebody out to play, the ligaments heal improperly, the ankle doesn't fit as tightly as it should, and often the result is arthritis."
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The researchers used MRI and x-rays to study 18 candidates for the 2005 professional football draft who were found to have a history of high ankle sprain. Fourteen x-rays showed an abnormal growth of new bone, known as periostosis, at the lower part of the tibia, the large bone between the knee and foot. Two MRI exams revealed abnormal swelling due to fluid at the same site.
According to Dr. Towers, this periostosis provides physicians with an indirect sign of high ankle sprain that is decisive in diagnosing this difficult-to-detect injury.
"Even if I don't have MR images that include the entire syndesmosis, which goes into the lower leg," Dr. Towers said, "if I look at an ankle and see this posterior periostosis, I can now be fairly sure of a syndesmotic injury."
Co-authors on both studies are Derek Armfield, M.D., James Bradley, M.D., John Norwig, M.E.D., from University of Pittsburgh Medical Center and Kenneth Buckwalter, M.D., from Indiana University Medical Center, which coordinates imaging for the professional football draft.
About RSNA
RSNA is an association of more than 38,000 radiologists, radiation oncologists, medical physicists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill.
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