Role of Magnetic Resonance Imaging in Evaluation of Ankle Impingement Syndrome

Background: Ankle impingement is the painful mechanical restriction of complete ankle range of motion caused by an osseous or soft-tissue deformity. Ankle impingement syndromes are prevalent and significant post-traumatic sources of morbidity in professional and amateur sports. The aim of this research is to evaluate the role of Magnetic Resonance Imaging (MRI) in diagnosis of ankle impingement syndromes.

Methods: This prospective study was performed on 40 consecutive patients aged from 20 to 55 years old, with clinical diagnosis of ankle impingement, 21 (52.5%) of them were males and 19 (47.5%) were females. All patients were subjected to full history taking [personal history, history of present illness (onset, course and duration; pain, swelling, limitation of movement, and other symptoms)], clinical Examination was carried out by the colleagues in the Orthopaedic department and MRI examination where all patients were examined with closed superconductive 1.5 T magnet (GE SIGNA Explorer), using the extremity coils.

Results: 26 out of the 28 cases with clinically suspected posterior impingement were correctly diagnosed by MRI (sensitivity of 92.86%, specificity of 100% and accuracy of 92.86%) and other two cases showed synovial effusion. 3 out of the 4 cases with clinically suspected anterolateral impingement were correctly diagnosed by MRI (sensitivity of 75%, specificity of 100% and accuracy of 75%) and other case showed sinus tarsi. All the 4 cases with clinically suspected anterior, anterolateral impingement were correctly diagnosed by MRI (sensitivity of 100%, specificity of 100% and accuracy of 100%). Totally, MRI sensitivity in diagnosis impingement was 92.5%, specificity was 100% and accuracy was 92.5%).

Conclusions: MRI exhibits excellent overall sensitivity, specificity, and accuracy in the diagnosis of ankle impingement. MRI displays rather definite anatomic and pathologic details, with outstanding outlining of both bony and soft tissue structures. Moreover, it assists in the exclusion of other mimic similar conditions.