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Comparison between MRI and arthroscopy in detecting lesions following unresolved pain in severe ankle sprains

Background Ankle sprains are a very common form of sports injury, and a large number of such injuries result in significant unresolved ankle problems. Capitalizing on the recent advances in ankle arthroscopy techniques, we have compared the results of evaluation of patients with these complaints using MRI scans versus what is seen and treated using ankle arthroscopy. Patients and methods Between 2009 and 2011 we have treated 25 cases of unresolved pain following severe ankle sprains. The mean age of the patients was 36.2 years. There were 17 male and eight female patients; all of them had residual ankle pain at least 6 months following a severe ankle sprain. Patients were subjected to MRI scan, following which they all underwent an ankle arthroscopy procedure as a treatment modality for their symptoms. The ankle arthroscopy findings were compared with the preoperative MRI findings. Results Seventeen of our patients had meniscoid lesions and anterior tibiofibular ligament injuries during arthroscopy, of which only 12 were seen on preoperative MRI (70.5%). Fourteen patients had chondral lesions, of which only 11 were seen on MRI (78.5%). Lateral collateral ligament calcification seen in three cases could only be detected by means of preoperative MRI in one case (33.3%), and there was one case of a loose body, which was not detected on MRI (0%). Conclusion MRI scan is not an alternative to ankle arthroscopy in treating patients with residual symptoms following severe ankle sprains. Increasing the strength of MRI magnet and a learning curve in reading these scans may help in increasing its sensitivity.