DIAGNOSTIC ACCURACY OF ULTRASOUND IN DIAGNOSIS OF ANKLE LIGAMENTOUS INJURIES KEEPING MRI AS GOLD STANDARD

Abstract

Objective: To determine the diagnostic accuracy of ultrasonography in detecting ankle ligamentous injuries using magnetic resonance imaging as the gold standard.

Study duration: March 2025 to June 2025

Methods: This cross-sectional validation study was conducted on 175 patients aged 18–60 years presenting with suspected ankle ligamentous injuries. All patients underwent ultrasonography followed by MRI. The anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament were assessed. MRI findings were considered the gold standard. Diagnostic parameters including sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were calculated. Data were analyzed using SPSS version 26.

Results:  The mean age of participants was 36.8 ± 7.5 years, with a male predominance (60.7%). The anterior talofibular ligament was the most commonly involved structure (65.5%). Ultrasonography demonstrated 78 true positives, 32 true negatives, 17 false positives, and 18 false negatives. The sensitivity and specificity of ultrasonography were 81.3% and 65.3%, respectively. The positive predictive value was 82.1%, while the negative predictive value was 64.0%. Overall diagnostic accuracy was 75.9%.

Conclusion: Ultrasonography showed good sensitivity and moderate specificity in diagnosing ankle ligamentous injuries. It is a reliable and accessible imaging modality for initial evaluation, particularly for anterior talofibular ligament injuries. However, due to its limited specificity and lower negative predictive value, MRI remains essential for confirmation in equivocal or negative cases with strong clinical suspicion