Volume measurements on weightbearing computed tomography can detect subtle syndesmotic instability

While weightbearing computed tomography (WBCT) allows three‐dimensional (3D) visualization of the distal syndesmosis, image interpretation has largely relied on one‐dimensional (1D) distance and, more recently, two‐dimensional (2D) area measurements. This study aimed to (1) determine the sensitivity...

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Bibliographic Details
Published in:Journal of orthopaedic research 2022-02, Vol.40 (2), p.460-467
Main Authors: Ashkani Esfahani, Soheil, Bhimani, Rohan, Lubberts, Bart, Kerkhoffs, Gino M., Waryasz, Gregory, DiGiovanni, Christopher W., Guss, Daniel
Format: Article
Language:English
Subjects:
accuracy
Ankle Injuries - diagnostic imaging
Ankle Joint - diagnostic imaging
Humans
image interpretation
Joint Instability - diagnostic imaging
Retrospective Studies
sensitivity
specificity
stress imaging
syndesmosis
Tomography, X-Ray Computed - methods
Weight-Bearing
weightbearing CT
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Summary:While weightbearing computed tomography (WBCT) allows three‐dimensional (3D) visualization of the distal syndesmosis, image interpretation has largely relied on one‐dimensional (1D) distance and, more recently, two‐dimensional (2D) area measurements. This study aimed to (1) determine the sensitivity and specificity of 2D area and 3D volume WBCT measurements towards detecting subtle syndesmotic instability, (2) evaluate whether the patterns of changes in the 3D shape of the syndesmosis can be attributed to the type of ligament injury. A total of 24 patients with unilateral subtle syndesmotic instability and 24 individuals with uninjured ankles (controls) with bilateral ankle WBCT were assessed retrospectively. First, 2D areas at 0, 1, 3, 5, and 10 cm, and 3D volumes at 1, 3, 5, and 10 cm above the tibial plafond were measured bilaterally. Secondly, the 3D model of the distal tibiofibular space was created based on WBCT in a subset of 8 out of 24 patients in whom the type of ligament injury was recognized via magnetic resonance imaging. The 3D model of the injured side was superimposed on the uninjured contralateral side to visualize the pattern of changes in different planes. Volume measurement up to 5 cm above the tibial plafond showed the lowest p‐value (
ISSN:0736-0266
1554-527X
DOI:10.1002/jor.25049