This presentation will predominantly bring together methods for scanning all regions of the ankle and midfoot to result in a thorough front-line approach to ligament injury in the acute setting.
While alternative diagnostic techniques exist, each offering varying degrees of accuracy, expense and time, it is posited that ultrasound is an accurate, cost-effective, and efficient modality for front-line assessment in acute and subacute ankle sprains.
Ultrasound examination is often confined to the lateral ligament complex due to operator inexperience or the ingrained perception that its use in other regions of the ankle is limited. However, if the scope of an ultrasound examination is not extended to include the midfoot, syndesmosis and medial ankle, more time-critical injuries may be missed leading to poor patient management and recovery.
The following demonstrations will be given in support of this posit:
1. Correct probe positioning to find important midfoot ligaments
2.Correct dynamic stress-ultrasound for detection of tibiofibular diastasis in the setting of AITFL ligament disruption (high ankle sprain)
3. Correct patient positioning to optimally visualise the components of the medial ankle deltoid ligament.
It will be seen that such ultrasound techniques can be used to obtain comparative views; allow for accurate appraisals of the tibiofibular syndesmosis, midfoot and deltoid ligaments (along with routine lateral ligament complex assessment). Dynamic positioning of the ankle or stress-ultrasound during assessment can assist with triage and ensure that best patient management is provided.