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Musculoskeletal Imaging |
1 From the Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, University of Toronto, 600 University Ave, Toronto, Ontario, Canada M5G 1X5 (P.R., L.M.W., D.C.S.); Department of Orthopaedic Surgery, St Michael’s Hospital, University of Toronto, Ontario, Canada (T.R.D.); and Department of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Ontario, Canada (D.O.H.). From the 2000 RSNA scientific assembly. Received October 16, 2000; revision requested November 28; revision received February 5, 2001; accepted March 19. Supported in part by the 2000 RSNA Fellowship Trainee Prize. Address correspondence to L.M.W. (e-mail: lwhite@mtsinai.on.ca).
PURPOSE: To determine the accuracy of magnetic resonance (MR) arthrography in assessing the anterolateral recess of the ankle.
MATERIALS AND METHODS: Thirty-two patients with chronic ankle pain prospectively underwent gadolinium-enhanced MR arthrography of the tibiotalar joint. All underwent clinical examination and were included if anterolateral impingement (n = 13) or a control condition (n = 19; suspected osteochondral defect, intraarticular bodies, instability, osteoarthritis) was diagnosed. MR imaging included transverse and coronal T1-weighted and sagittal T2-weighted imaging sequences. Images were prospectively analyzed by two readers blinded to the clinical diagnosis. The anterolateral gutter contour was assessed. MR arthrographic findings were correlated with subsequent arthroscopic appearances.
RESULTS: MR arthrographic assessment of the anterolateral soft tissues had an accuracy of 97%, sensitivity of 96%, specificity of 100%, negative predictive value of 89%, and positive predictive value of 100%. Accuracy was 100% with clinical anterolateral impingement, with an arthroscopically confirmed abnormality in 12 cases and a normal appearance in one. Anterolateral soft-tissue thickening was identified at MR arthrography in 11 control cases, with arthroscopic confirmation in all. The remaining cases had normal appearances, with an arthroscopic soft-tissue abnormality in one case and a normal appearance in seven.
CONCLUSION: MR arthrography of the tibiotalar joint is accurate in assessing the anterolateral recess of the ankle.
Index terms: Ankle, abnormalities, 463.486 • Ankle, injuries, 463.486 • Ankle, MR, 463.1214 • Magnetic resonance (MR), arthrography, 463.12149, 463.12143
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