Ultrasound examination for the diagnosis of chronic anterior talofibular ligament injury

Background: Anterior talofibular ligament (ATFL) injury is a commonly seen sports-related injury and a major underlying pathology of chronic ankle instability. However, it is difficult to accurately identify chronic injury of the ATFL. Purpose: To investigate the value of ultrasound (US) examination in identifying chronic ATFL injury. Material and Methods: We evaluated 83 consecutive patients who underwent US examination for diagnosis of the ATFL injury and subsequent ankle arthroscopy. The arthroscopic findings were used as the reference standard. Results: Forty-four patients were found to have ATFL injury on arthroscopy. The accuracy of US examination for the detection of ATFL injury was 95.2%, with sensitivity of 97.7%, specificity of 92.3%, positive predictive value of 93.5%, negative predictive value of 97.3%, positive likelihood ratio of 12.7, and negative likelihood ratio of 0.025. Conclusion: US examination is a reliable and accurate method to evaluate chronic ATFL injury.