Assessment of Osteochondral Lesions of the Talus with Ultrasonography a Prospective Study with Computed Tomography Arthr
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IMAGING
Assessment of Osteochondral Lesions of the Talus with Ultrasonography a Prospective Study with Computed Tomography Arthrography as the Gold Standard Sofiane Boudahmane 1 & Thibaut Dubreuil 2,3 & Lionel Pesquer 2 & Guillaume Cordier 4 & Stéphane Guillo 4 & Sylvain Bise 2 & Benjamin Dallaudière 2,5 Accepted: 26 April 2020 / Published online: 11 May 2020 # Springer Nature Switzerland AG 2020
Abstract The purpose of this study was to evaluate the reliability of ultrasonography (US) for the diagnosis and characterization of osteochondral lesions of the talus (OLT), compared with computed tomography arthrography (CTA) as the gold standard. Eighty-one patients were enrolled from May 2018 to May 2019, consulting initially for ankle instability. US and CTA were performed the same day for each patient by an experienced skeletal radiologist. Images were analyzed in consensus. The primary outcome, detection of OLT, was calculated with Cohen’s kappa method test. Secondary outcomes were localization and size of osteochondral lesions. Four patients were positive on US (4.9%); 12 lesions were detected by CTA (14.8%). No false positives were found by US. Predominant locations were zones 4 (41.7%) and 6 (25%). Average surface area of OLT on US was 24.2 and 79.2 mm2 on CTA. Specificity for OLT detection by US was 100% and sensitivity 33%. Agreement factor kappa was 0.46 (Z = 1.96; po = 0.9; pc = 0.82). OLT size was significantly different (p > 0.5) between US and CTA. US had very high specificity (100%) but very low sensitivity (33%) for detecting OLT in ankle sprains, with no size correlation. Given the high US specificity, it would be useful to perform systematic anterior talus assessment in ankle injuries; any detection of OLT would enable prompt specialist referral of patients and CTA imaging. Keywords Ankle . Ultrasonography . Cartilage . Talus . OLT
Introduction This article is part of the Topical Collection on Imaging * Benjamin Dallaudière [email protected] 1
Service d’imagerie diagnostique et de radiologie thérapeutique, Centre Hospitalier Universitaire de Caen, Avenue de la Côte de Nacre, 14000 Caen, France
2
Centre d’Imagerie Ostéo-articulaire Clinique du Sport de Bordeaux-Mérignac, 2 rue Georges Negrevergne, 33700 Mérignac, France
3
Service de Radiologie Centre,, Hospitalier Universitaire Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69310 Pierre-Bénite, France
4
Département de Chirurgie Orthopédique, Clinique du Sport de Bordeaux-Mérignac, 4 rue Georges Negrevergne, 33700 Mérignac, France
5
Département d’Imagerie Musculo-squelettique, Centre Hospitalier Universitaire Pellegrin, Place Amélie-Léon-Rabat, 33000 Bordeaux, France
Osteochondral lesions of the talus (OLT) are mainly posttraumatic and can occur in up to 70% of ankle sprains and fractures [1]. Those OLT can cause persistent abnormalities in the ankle and are a major risk-factor for early osteoarthritis (OA). Clinically, patients present with poorly localized ankle pain and there is no specific clinical examination or
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