Ayak bileği anterolateral kapsüloligamentöz kompleks ve resesin sonoartrografik incelenmesi ve MR artrografik korelasyonu
Küçük Resim Yok
Tarih
2025
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmamızda, ultrasonografi (USG) ve sonoartrografi yöntemlerini manyetik rezonans artrografi (MRA) ile karşılaştırarak ayak bileği eklemi anterolateral reses ve kapsüloligamentöz kompleksin patolojilerini saptama ve tanımlamadaki katkılarını araştırmayı amaçladık. Materyal ve metot: Kasım 2023 ile Ocak 2024 tarihleri arasında hastanemizin Ortopedi ve Travmatoloji Anabilim Dalı veya Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı polikliniğine başvuran kronik ayak bileği ağrısı şikayeti bulunan, fizik muayenede ayak bileği anterolateral yapılarında patolojiden şüphelenilen ve artrografi endikasyonu bulunan 40 hastaya USG, Sonoartrografi ve MRA yapıldı. USG ve sonoartrografik incelemede, anterior talofibular ligaman (ATFL) bütünlüğü, hasar var ise parsiyel veya komplet şeklinde tiplendirilmesi, anterolateral eklem kapsülünde kalınlaşma varlığı, var ise nodüler veya diffüz olarak sınıflandırılması, anterolateral eklem resesinde obliterasyon varlığı iki ayrı radyolog tarafından birbirinden bağımsız olarak değerlendirildi. MRA görünütülerinde anterolateral reses patolojilerinin tanısı radyologların konsensusu ile konuldu. USG ve sonoartrografi inceleme için altın standart MRA kabul edilerek sensitivite, spesifite, pozitif prediktif değer, negatif prediktif değer ve tanısal doğruluk oranları hesaplandı. Gözlemciler arası uyum istatistiki olarak değerlendirildi. Bulgular: Çalışmaya 23'ü erkek, 17'si kadın toplam 40 olgudan elde edilen USG, sonoartrografi ve MRA incelemeleri dahil edildi. Herbir hasta her üç tetkike de sahipti. Sonoartrografinin iki gözlemci için sensitivite, spesifite ve tanısal doğruluk oranları, eklem kapsülünde %58-47, %90-86, %75-68, anterolateral reseste %45-46, %93-93, %80-80 ve ATFL'de %67-67, %94-94, %90-90 olarak bulundu. USG verilerinde eklem kapsülü, anterolateral reses ve ATFL için gözlemciler arasında önemli derecede uyum saptandı. Sonoartrografik incelemede ise eklem kapsülü ve anterolateral reses için gözlemciler arası neredeyse mükemmel uyum ve ATFL için mükemmel uyum vardı. Sonuç: Bizim çalışmamız sonoartrografinin anterolateral eklem resesi ve kapsüloligamentöz komplekste patolojiyi tanımlamada yüksek hassasiyet, özgüllük ve gözlemciler arası uyum ile tanı için ucuz, ulaşılabilir bir alternatif olabileceğini gösterdi.
Objective: Our study aims to evaluate the diagnostic contribution of ultrasonography (USG) and sonoarthrography in detecting and characterizing pathologies of the anterolateral recess and capsuloligamentous complex of the ankle joint, using magnetic resonance arthrography (MRA) as a reference approach. Materials and Methods: Between November 2023 and January 2024, USG, sonoarthrography, and MRA examinations were performed on 40 patients who presented to the Orthopedics and Traumatology or Physical Medicine and Rehabilitation Department of our hospital with chronic ankle pain with the exhibition of suspicious pathologies in the anterolateral structures of the ankle joint upon physical examination and met the indications for arthrography. In all three imaging modalities, the integrity of the anterior talofibular ligament (ATFL) was assessed, and if a lesion was present, it was classified as either partial or complete. Additionally, thickening of the anterolateral joint capsule, if detected, was categorized as nodular or diffuse, and the presence of obliteration in the anterolateral joint recess was evaluated. Two independent radiologists interpreted the images separately. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated, by considering MRA as the gold standard. Interobserver agreement was also statistically analyzed. Findings: Examinations of three methods which are ultrasonography (USG), sonoarthrography and MRA of 40 cases (23 males and 17 females) were included in the study. MRA was designated as the gold standard. The sensitivity, specificity, and diagnostic accuracy rates of sonoarthrography for the joint capsule were 58-47%, 90-86%, and 75-68%, respectively; for the anterolateral recess, these values were 45-46%, 93-93%, and 80-80%, respectively; and for the ATFL, they were 67-67%, 94-94%, and 90-90%, respectively. In USG data, substantial interobserver consistency was observed for the joint capsule, anterolateral recess, and ATFL. In sonoarthrographic examination, there was almost perfect interobserver consistency for the joint capsule and anterolateral recess, while perfect consistency for the ATFL was observed. Conclusion: Our findings indicate that sonoarthrography is a cost-effective and accessible alternative imaging modality with high sensitivity, specificity, and interobserver consistency in the assessment of anterolateral recess and capsuloligamentous complex pathologies of the ankle joint.
Objective: Our study aims to evaluate the diagnostic contribution of ultrasonography (USG) and sonoarthrography in detecting and characterizing pathologies of the anterolateral recess and capsuloligamentous complex of the ankle joint, using magnetic resonance arthrography (MRA) as a reference approach. Materials and Methods: Between November 2023 and January 2024, USG, sonoarthrography, and MRA examinations were performed on 40 patients who presented to the Orthopedics and Traumatology or Physical Medicine and Rehabilitation Department of our hospital with chronic ankle pain with the exhibition of suspicious pathologies in the anterolateral structures of the ankle joint upon physical examination and met the indications for arthrography. In all three imaging modalities, the integrity of the anterior talofibular ligament (ATFL) was assessed, and if a lesion was present, it was classified as either partial or complete. Additionally, thickening of the anterolateral joint capsule, if detected, was categorized as nodular or diffuse, and the presence of obliteration in the anterolateral joint recess was evaluated. Two independent radiologists interpreted the images separately. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated, by considering MRA as the gold standard. Interobserver agreement was also statistically analyzed. Findings: Examinations of three methods which are ultrasonography (USG), sonoarthrography and MRA of 40 cases (23 males and 17 females) were included in the study. MRA was designated as the gold standard. The sensitivity, specificity, and diagnostic accuracy rates of sonoarthrography for the joint capsule were 58-47%, 90-86%, and 75-68%, respectively; for the anterolateral recess, these values were 45-46%, 93-93%, and 80-80%, respectively; and for the ATFL, they were 67-67%, 94-94%, and 90-90%, respectively. In USG data, substantial interobserver consistency was observed for the joint capsule, anterolateral recess, and ATFL. In sonoarthrographic examination, there was almost perfect interobserver consistency for the joint capsule and anterolateral recess, while perfect consistency for the ATFL was observed. Conclusion: Our findings indicate that sonoarthrography is a cost-effective and accessible alternative imaging modality with high sensitivity, specificity, and interobserver consistency in the assessment of anterolateral recess and capsuloligamentous complex pathologies of the ankle joint.
Açıklama
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine, Sonoartrografi, Manyetik Rezonans Artrografi, Anterior Talofibular Ligament, Ayak Bileği İnstabilitesi, Anterolateral İmpingement, Sonoarthrography, Magnetic Resonance Arthrography, Anterior Talofibular Ligament, Ankle Instability, Anterolateral Impingement
