July’s 5 minute Assessment assistant
Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain
Clinical assessment of Syndesmotic injury usually consists of two tests: the ankle external rotation test and squeeze test. This study sought to determine the sensitivity and specificity of both for Syndesmotic injury secondary to lateral ankle sprain.
Fifty-six patients with a history of ankle sprain
Patients underwent clinical examination for Syndesmotic injury with the ankle external rotation and squeeze tests. Clinical findings were compared against MRI of the ankle.
Squeeze test: Sensitivity: 30%, Specificity: 93.5%
External Rotation test: Sensitivity: 20%, Specificity: 84.5%
In a nutshell…
MRI prevalence of syndesmotic injury in patients with lateral ankle sprains was 17.8% which is higher than most would expect. The sensitivity of both tests appear poor however they are very strong ways to ‘rule it in.’
To perform the…
- Squeeze test: squeeze the proximal Fibula and Tibia together in an effort to reproduce pain.
- External Rotation test: With the patient sitting and the ankle in a neutral position, externally rotate the foot in an effort to reproduce the patient’s pain.
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de César PC, Avila EM, de Abreu MR. Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot Ankle Int. 2011 Dec;32(12):1110-4. doi: 10.3113/FAI.2011.1110. PMID: 22381194.