Pediatric versus adult magnetic resonance imaging patterns in acute high ankle sprains.

Autor: Walter WR; Department of Radiology, New York University Langone Health, 301 E. 17th St., 6th Floor, New York, NY, 10003, USA. William.Walter@nyulangone.org., Alaia EF; Department of Radiology, New York University Langone Health, 301 E. 17th St., 6th Floor, New York, NY, 10003, USA., Samim M; Department of Radiology, New York University Langone Health, 301 E. 17th St., 6th Floor, New York, NY, 10003, USA., Rosenberg ZS; Department of Radiology, New York University Langone Health, 301 E. 17th St., 6th Floor, New York, NY, 10003, USA.
Jazyk: angličtina
Zdroj: Pediatric radiology [Pediatr Radiol] 2021 Oct; Vol. 51 (11), pp. 2047-2057. Date of Electronic Publication: 2021 May 19.
DOI: 10.1007/s00247-021-05101-z
Abstrakt: Background: There is a paucity of literature describing MRI patterns of high ankle sprains in pediatric patients. Radiologists should understand MRI patterns of these injuries in both adults and children.
Objective: To describe normal MRI appearance of pediatric syndesmotic ligaments and compare MRI patterns of high ankle sprains in children versus adults.
Materials and Methods: We reviewed consecutive ankle MRIs performed over 3 years and divided them into three cohorts: a normal pediatric (≤16 years) cohort, and pediatric and adult cohorts with acute/subacute ankle syndesmosis injuries. Our retrospective review assessed interobserver agreement (Cohen kappa coefficient) and normal pediatric syndesmotic anatomy. We compared patterns of high ankle sprains (Fisher exact test) including ligament tears, periosteal stripping, avulsions and fractures.
Results: Of the 582 ankle MRIs, we included 25 in the normal pediatric cohort, 20 in the pediatric injury cohort and 23 in the adult injury cohort. The anterior and posterior tibiofibular ligaments all attached to cortex or cartilaginous precursor, while the interosseous ligament/membrane complex attached to the fibrous periosteum in 22/25 (88%) normal pediatric cases. Tibial periosteal stripping at the interosseous ligament/membrane complex attachment occurred in 7/20 (35%) pediatric and 1/23 (4%) adult injury cases (P=0.02). No other statistically significant differences were found. Interobserver agreement ranged from kappa=0.46 to kappa=0.82 (ligament tears), 0.38 to 0.45 (avulsions) and 0.69 to 0.77 (periosteal stripping).
Conclusion: The normal interosseous ligament/membrane complex typically attaches to fibrous periosteum rather than bony cortex. Tibial periosteal stripping, usually without tibial fracture, is significantly more common among pediatric high ankle sprains. MRI patterns of high ankle sprains are otherwise not significantly different between children and adults.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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