VALUE OF ARTHROGRAPHY AFTER SUPINATION TRAUMA OF THE ANKLE

Objective. To investigate the merits of arthrography after supination trauma of the ankle. Design and patients. In a group of 160 consecutiv e patients operative exploration was performed in cases where arthrogr aphy and/or a delayed physical examination showed positive findings. I n all patients arthrography was performed within 48 h after trauma. To determine interobserver agreement, all arthrograms were independently evaluated by two radiologists, both ignorant of the first assessment. Results. The prevalence of an ankle Ligament lesion was found to be 7 6%. Of the 122 patients with a rupture of one or more ankle ligaments, 52% had an isolated anterior talofibular ligament lesion, 3% had an i solated calcaneofibular ligament lesion, and 45% had combined lesions. The site of the lesion was predominantly intraligamentous. In the det ermination of the presence or absence of an ankle ligament lesion, the specificity and sensitivity of the ankle arthrogram were 71% and 96% respectively. Interobserver agreement on the arthrogram was very good (kappa 0.9), In 1% of patients a clear diagnosis was not possible by m eans of arthrography. Conclusion. Arthrography provides information of high diagnostic quality with excellent interobserver agreement and th erefore remains the gold standard for early diagnosis (within 48 h) of a lateral ankle ligament rupture.