STANDARDIZED SONOGRAPHIC DIAGNOSTIC PROCE DURE FOR ANKLE JOINT INSTABILITY AFTER SEVERE ANKLE SPRAINS

The anterior drawer was evaluated sonographically under standard condi tions (150 N load, 7.5 MHz linear scanner) in 95 patients with severe ankle sprain. A simple geometric construct of subsidiary lines set up with the help of a goniometer on the videoprints (enlargement 1.5 X) e nabled a standardized interpretation of the anterior drawer (pathologi c greater than or equal to 3 mm). Thus, the definition of poorly repro ducible reference points for sonographic measurements became avoidable . In 60 patients a rupture of the lateral ankle ligaments was diagnose d, in 35 patients the findings were recorded as severe ankle sprains w ithout ligament rupture. Compared with the radiological anterior drawe r and talar tilt, the dynamic sonographic measurement of the anterior drawer showed the better values from the aspects of sensitivity, speci ficity and accuracy (greater than or equal to 0.93). In our own practi ce sonographic measurement of anterior drawer has replaced stress radi ograms in diagnosis of ankle joint instabilities after severe ankle sp rains.