Ultrasound assessment of lateral ankle ligament alterations and correlation with clinical tests in acute ankle sprain: A prospective cross-sectional study

Objectives: An acute ankle sprain represents one of the most prevalent musculoskeletal injuries, with approximately 85% of cases classified as lateral ankle sprains. Although the diagnosis is primarily clinical, ultrasound serves as the preferred initial imaging modality for evaluating acute ankle sprains. The study examined the efficacy of ultrasound in evaluating the thickness of lateral ligaments in patients experiencing acute ankle sprains, and it analyzed the correlation between ultrasound findings and clinical assessments. Material and Methods: The study was conducted at a tertiary care center located in North India over a duration of 1.5 years. A total of fifty patients presenting with acute ankle sprains of <2 weeks’ duration were enrolled in the research. All patients underwent clinical tests for acute ankle sprains, followed by ultrasonographic evaluation of both the injured and uninjured limbs to assess the anterior talofibular ligament (ATFL), anterior inferior tibiofibular ligament (AITFL), and calcaneofibular ligament (CFL) complex. Results: A statistically significant difference (>20% thickness difference) was found in the thickness of the ATFL, AITFL, and CFL between the injured and uninjured limbs of the same patient, with a P < 0.001. Compared to clinical tests, ultrasound was more sensitive in diagnosing acute ligamentous injuries. Conclusion: Ultrasound has demonstrated superior efficacy compared to clinical assessments in the detection of ankle ligament injuries associated with acute ankle sprains. This imaging modality is valuable not only in evaluating ligament thickness but also in assessing various ultrasonographic morphological changes, including the fibrillary pattern and echogenicity of the injured ligaments.