Dados do Trabalho

Título

Distal tibiofibular syndesmotic instability: revisiting essential concepts and clarifying advacend imaging tests

Introdução e objetivo(s)

It is vital not only to diagnose the syndesmotic ligament injury but also to address the degree of joint instability, as the latter guides treatment decision-making, according to the West Point grading system. Although controversial, unstable syndesmotic injuries are generally treated surgically, and stable injuries are conservative. In this scenario, diagnostic tests play an essential role; however, clinical tests, radiographs, conventional computed tomography (CT), weight-bearing computed tomography (WBCT), and magnetic resonance imaging (MRI) have limitations in adequately detecting the full spectrum of instability, particularly grade IIB, also known as subtle, latent, or dynamic instability.
This narrative review aims to provide an easy understanding of the anatomy and biomechanics and a comprehensive description of the benefits and drawbacks of conventional and advanced imaging tests in diagnosing isolated syndesmotic instability.

Método(s)

This will be accomplished through schematic drawings and didactic cases, including therapies and post-treatment findings.

Discussão

Despite all available imaging tools, diagnosing syndesmotic instability is still challenging. Rapid identification of frank syndesmotic instability can be achieved through conventional imaging assessments. Nevertheless, more subtle instabilities may go unnoticed during unilateral exams, and comparing them with the healthy contralateral side is crucial. Assessing the full spectrum of syndesmotic instability with conventional imaging tests is limited. To overcome these limitations, CT scan with stress maneuvers has emerged as a promising method with excellent accuracy, specifically in diagnosing dynamic instability.

Conclusões

In summary, this review offers a comprehensive understanding of syndesmotic instability and can serve as a valuable resource for radiologists seeking to expand their knowledge on the subject.

Palavras Chave

Syndesmosis; ankle; instability

Arquivos