AOSSM 2022 Annual Meeting Recordings - no CME-Diagnostic Accuracy of Weightbearing CT in Detecting Chronic Subtle Syndesmotic Instability: A Prospective Comparative Study

Diagnostic Accuracy of Weightbearing CT in Detecting Chronic Subtle Syndesmotic Instability: A Prospective Comparative Study

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Video Transcription

Video Summary

In the video, Alan Shamrock discusses the role of weight-bearing CT in diagnosing syndesmotic instability in the chronic setting. Foot and ankle injuries, particularly syndesmosis injuries or high ankle sprains, are common in athletes and prompt diagnosis and treatment are critical to prevent complications. Currently, ankle arthroscopy is the gold standard for diagnosis, but it is invasive and costly. Weight-bearing CT offers a non-invasive alternative that allows for the assessment of syndesmosis under a physiologic load. Previous studies have shown promising results in diagnosing acute injuries, but there is a lack of literature regarding chronic injuries. Shamrock's study aimed to evaluate the accuracy of weight-bearing CT in detecting chronic subtle syndesmotic instability. The study enrolled patients with suspected chronic injuries and normal imaging. The patients underwent weight-bearing CT prior to ankle arthroscopy. The results showed that weight-bearing CT performed poorly in diagnosing chronic injuries, with an accuracy of only 36% for area measurements and 45% for volumetric measurements. Larger sample sizes and the introduction of external rotation stress could potentially improve its diagnostic capability in the chronic setting. Overall, weight-bearing CT may have limitations in detecting chronic syndesmotic instability and further research is needed. No specific credits are granted in the video.

Asset Caption

Alan Shamrock, MD

Keywords

weight-bearing CT

syndesmotic instability

chronic setting

ankle arthroscopy

diagnosis