Table 1 Summary of assessments for ankle injury
From: Understanding acute ankle ligamentous sprain injury in sports
Testes | Descriptions (Sensitivity and specificity included if data is available) |
Lynam [94] | An examination to assess acute foot and ankle sprain at emergency room. |
Harmon [95] | A systematic approach that consists of five steps to avoid missing potentially serious injuries. |
Ottawa ankle rules [97] | Rules to decide whether patients with acute ankle injury need X-ray or radiography. 100% sensitivity and 40% specificity for detection of malleolus fractures. |
Stress radiography was performed with manual maximum force in inversion. The talar tilt was measured as the angle between the horizontal skeletal joint surfaces of the talus and the tibia. | |
Assesses the stability of the ATFL by cupping the heel in one hand and pulling it forward while stabilizing the tibia with other hand. | |
Talar tilt test [102] | Both ATFL and CFL were accessed, while ankle is inverted and the laxity was compared with that of the uninjured side. |
Eversion stress test [103] | Heel was gently grasped with one hand, and the tibia with the other hand. A varus and then a valgus tilt stress were applied to the heel. |
External rotation test [50] | Knee and ankle at 90 degree and a force with external rotation is applied to the midfoot area. Test is positive with pain. |
5-point grading system using noninvasive, high-resolution MRI to evaluate the articular cartilage of the talar dome. Sensitivity is 39% and Specificity is 50% for diagnose ankle-ligamentous injury. | |
Arthography [105] | After passive manipulation of the foot for 2 min, radiographs were obtained in 20 degrees internal rotation, anteroposterior projection, 40 degrees external rotation, lateral projection, and a soft tissue view just caudal to the lateral malleolus. Sensitivity is 100%. |
Sonography [106] | Patient lay on the side of unaffected leg with the knee joint flexed to 90 degrees, while the affected leg was only slightly flexed. Sensitivity is 92% and specificity is 83%. |
3D computed tomography [107] | 3D CT images were obtained with a multidirector CT scanner. The patient was placed in supine position with the neutral position of bilateral ankle joint. Accuracy to diagnose ATFL tears is 94.4%. |