Skeletal Radiology

, Volume 42, Issue 11, pp 1537–1542 | Cite as

Relationship between stress ankle radiographs and injured ligaments on MRI

  • Kyoung Min Lee
  • Chin Youb Chung
  • Soon-Sun Kwon
  • Myung Ki Chung
  • Sung Hun Won
  • Seung Yeol Lee
  • Moon Seok Park
Scientific Article



This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs.

Materials and methods

Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed.


Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs.


ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability.


Lateral instability Ankle Stress radiograph MRI 



The authors thank Mi Sun Ryu and Hyun Mi Kim for technical support.

Conflict of interest

The authors have no conflicts of interest to report.


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Copyright information

© ISS 2013

Authors and Affiliations

  • Kyoung Min Lee
    • 1
  • Chin Youb Chung
    • 1
  • Soon-Sun Kwon
    • 2
  • Myung Ki Chung
    • 1
  • Sung Hun Won
    • 1
  • Seung Yeol Lee
    • 1
  • Moon Seok Park
    • 1
  1. 1.Department of Orthopaedic SurgerySeoul National University Bundang HospitalKyungkiSouth Korea
  2. 2.Biomedical Research InstituteSeoul National University Bundang HospitalKyungkiSouth Korea

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