US US can be used to evaluate for soft-tissue abnormalities, including tendon and ligament tears. In inflammatory arthritis, it can help in the assessment of disease activity and severity as well as detect subclinical pathology in early disease or after treatment [9]. US is ideal for dynamic assessment of peroneal tendon instability [10] and can be used to guide interventions [11]. Compared with some other modalities, US is less prone to artifacts, such as susceptibility, motion, magic angle, and streak artifact, but dynamic assessment may be limited in cases of pain. MRI MRI is the imaging test that globally evaluates all anatomic structures, including ligaments, tendons, cartilage, and bone [12,13]. Most studies have shown that MRI is highly accurate for evaluation of ligament, tendon, and The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Chronic Ankle Pain osteochondral abnormalities [14-16], although one study found statistically significant lower sensitivity for these abnormalities on MRI as compared to arthroscopy [17]. MRI can identify synovitis and impingement lesions, which can contribute to patient symptoms [18]. Discussion of Procedures by Variant Variant 1: Chronic ankle pain. Initial imaging. Radiography Radiography should be considered as the initial imaging study. Radiographs may reveal osteoarthritis, calcified or ossified intra-articular bodies, osteochondral abnormalities, stress fractures, or evidence of prior trauma. Ankle effusions may also be identified in the anterior ankle joint recess by radiography with 53% to 74% accuracy [19]. They are often associated with ligamentous injury or fracture [19].
Chronic Ankle Pain. US US can be used to evaluate for soft-tissue abnormalities, including tendon and ligament tears. In inflammatory arthritis, it can help in the assessment of disease activity and severity as well as detect subclinical pathology in early disease or after treatment [9]. US is ideal for dynamic assessment of peroneal tendon instability [10] and can be used to guide interventions [11]. Compared with some other modalities, US is less prone to artifacts, such as susceptibility, motion, magic angle, and streak artifact, but dynamic assessment may be limited in cases of pain. MRI MRI is the imaging test that globally evaluates all anatomic structures, including ligaments, tendons, cartilage, and bone [12,13]. Most studies have shown that MRI is highly accurate for evaluation of ligament, tendon, and The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Chronic Ankle Pain osteochondral abnormalities [14-16], although one study found statistically significant lower sensitivity for these abnormalities on MRI as compared to arthroscopy [17]. MRI can identify synovitis and impingement lesions, which can contribute to patient symptoms [18]. Discussion of Procedures by Variant Variant 1: Chronic ankle pain. Initial imaging. Radiography Radiography should be considered as the initial imaging study. Radiographs may reveal osteoarthritis, calcified or ossified intra-articular bodies, osteochondral abnormalities, stress fractures, or evidence of prior trauma. Ankle effusions may also be identified in the anterior ankle joint recess by radiography with 53% to 74% accuracy [19]. They are often associated with ligamentous injury or fracture [19].