Diagnostic Accuracy of Radiologic Methods for Ankle Syndesmosis Injury: A Systematic Review and Meta-Analysis

被引:41
|
作者
Chun, Dong-il [1 ]
Cho, Jae-ho [2 ]
Min, Tae-Hong [1 ]
Yi, Young [3 ]
Park, Su Yeon [4 ]
Kim, Kwang-Hyun [1 ]
Kim, Jae Heon [5 ]
Won, Sung Hun [1 ]
机构
[1] Soonchunhyang Univ Hosp Seoul, Dept Orthopaed Surg, 59 Daesagwan Ro, Seoul 04401, South Korea
[2] Hallym Univ, Chuncheon Sacred Heart Hosp, Dept Orthopaed Surg, 77 Sakju Ro, Chuncheon Si 200704, Gangwon Do, South Korea
[3] Inje Univ, Seoul Foot & Ankle Ctr, Dept Orthopaed Surg, 85,2 Ga, Seoul 100032, South Korea
[4] Soonchunhyang Univ Hosp Seoul, Dept Biostat, 59 Daesagwan Ro, Seoul 04401, South Korea
[5] Soonchunhyang Univ Hosp Seoul, Dept Urol, 59 Daesagwan Ro, Seoul 04401, South Korea
来源
JOURNAL OF CLINICAL MEDICINE | 2019年 / 8卷 / 07期
关键词
ankle; syndesmosis injury; ligament; diagnosis; TIBIOFIBULAR SYNDESMOSIS; SPRAINS; LIGAMENTS; INSTABILITY; FRACTURES; DIASTASIS; TESTS;
D O I
10.3390/jcm8070968
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Misdiagnosis and inadequate treatment of syndesmosis could result in significant long-term morbidity including pain, instability, and degenerative changes of the ankle joint. The objective of this systematic review and meta-analysis was to determine whether radiologic tests accurately and reliably diagnose ankle syndesmosis injury. Medline, Embase, and Cochrane were searched. The database search resulted in 258 full text articles that we assessed for eligibility, we used eight studies that met all the inclusion criteria. In subgroup meta-analysis, the sensitivity analysis showed significant differences only in the MRI (Magnetic Resonance Imaging), and specificity was not statistically significant. In diagnostic meta-analysis, the pooled sensitivity and specificity were 0.528 and 0.984 for X-rays, 0.669 and 0.87 for CT (Computed Tomography), and 0.929 and 0.865 for MRI, all respectively. For sensitivity, MRI showed significantly sensitivity as higher than the other methods, and we detected no significance for specificity. Syndesmosis injuries differed significantly in the accuracy of radiological methods according to the presence of accompanied ankle fractures. In patients with fractures, simple radiography has good specificity, and CT and MRI have high sensitivity and specificity irrespective of fracture; in particular, MRI has similar accuracy to gold standard arthroscopic findings.
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页数:14
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