Clinical Assessment of Ankle Instability: An Update on Which, When, Why

Background.Ankle sprains and Chronic ankle instability (CAI) are extremely common traumatic conditions that have a negative impact.Today, there is no accredited diagnostic protocol for identify and classify CAI patients.The purpose of this study is to report the most reliable clinical assessments in the literature on ankle instability and to try to propose a reliable and easily reproducible diagnostic algorithm.Methods.We searched PubMed for articles that included keywords such as: CAI, ankle instability, SEBT, Hop-Test and Functional test.We focused on the most recent articles, selecting those of greatest interest such as meta-analyzes and prospective studies.Finally, we focused on how the next diagnostic process could be constructed. Results and conclusions.From our research, it could be hypothesized that the most promising tests for a correct diagnosis of CAI are the ALDT, two hop tests, the foot lift, and the SEBT.In the patient with functional instability, a correct classification can derive from neurological Tests.Patient with negative radiological exams but with symptoms and positive clinical and functional tests, it would be advisable to investigate further with ankle arthroscopy.However, the major difficulty for a clinician in diagnosing CAI is represented by the total absence of cut-offs in the various functional tests and by a standardized diagnostic protocol.In our opinion, further studies need to be directed toward this goal.