Diagnostic accuracy of clinical tests assessing ligamentous injury of the ankle syndesmosis: a systematic review with meta-analysis

Review written by Dr Michael Reiman info

Key Points

  1. Despite many reported clinical tests for ankle syndesmosis injury (n=13), the clinical utility of such tests is quite limited.
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BACKGROUND & OBJECTIVE

Ankle sprains are among the most common injuries in physically active individuals. High ankle sprains (syndesmosis injuries) typically involve prolonged recovery (1), with time to return to sport being at least twice that after an isolated lateral ligament sprain (2).

Early diagnosis of ankle syndesmosis injuries is important for most appropriate care determination. Arthroscopic surgery is the gold standard for diagnosing this injury (3), but is invasive. Consensus guidelines recommend a variety of clinical tests, but the clinical utility of these tests is not clear. This paper sought to review the diagnostic accuracy of available tests.

Early diagnosis of ankle syndesmosis injuries is important for most appropriate care determination.
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Don’t put an over-reliance on special tests, or any single test in isolation.

METHODS

This paper was a systematic review searching three databases from inception to February 12, 2021. Studies comparing various clinical measures to arthroscopy, magnetic resonance imaging, or ultrasound were considered eligible. Meta-analysis was based on random effect modelling.

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