MRI It is generally accepted that MRI can achieve high sensitivities (>90%) in diagnosing ankle tendon tears [16]. Regarding tibialis posterior tendon, MRI is more sensitive than US; however, this difference did not significantly affect clinical management [37]. With regard to peroneal tendinopathy and tendon tear, one study found the sensitivities and specificities of MRI to be 83.9% and 74.5%, respectively, for tendinopathy and 54.5% and 88.7%, respectively, for tendon tears [48]. With regard to chronic Achilles tendinopathy, MRI detected 26 of 27 cases of tendinosis and partial rupture [39]. MRI reported a 66% accuracy rate for assessment for tendon subluxation and dislocation [44,45]. MRI evidence of peroneal tendon pathology should be treated with caution because up to 34% of asymptomatic patients may have a tear of the peroneus brevis tendon [49]. One study showed that MRI evidence of peroneal tendon pathology had a 48% positive predictive value for clinical findings, highlighting the importance of clinical examination [50]. Image-guided Anesthetic Injection In addition to the diagnostic capabilities of US, when a tendon abnormality is detected, a fluoroscopic or US- guided intrasheath anesthetic injection can be concurrently performed [11]. Tenography Diagnostic and therapeutic ankle tenography can also be considered for evaluation, with one study reporting that 47% of patients had prolonged relief of symptoms [51]. CT CT is not routinely used for the evaluation of suspected tendon abnormality. Bone Scan Bone scan is not routinely used for the evaluation of suspected tendon abnormality. CT Arthrography CT arthrography is not routinely used for the evaluation of suspected tendon abnormality. MR Arthrography MR arthrography is not routinely used for the evaluation of suspected tendon abnormality. Arthrography Arthrography is not routinely used for the evaluation of suspected tendon abnormality. Chronic Ankle Pain
Chronic Ankle Pain. MRI It is generally accepted that MRI can achieve high sensitivities (>90%) in diagnosing ankle tendon tears [16]. Regarding tibialis posterior tendon, MRI is more sensitive than US; however, this difference did not significantly affect clinical management [37]. With regard to peroneal tendinopathy and tendon tear, one study found the sensitivities and specificities of MRI to be 83.9% and 74.5%, respectively, for tendinopathy and 54.5% and 88.7%, respectively, for tendon tears [48]. With regard to chronic Achilles tendinopathy, MRI detected 26 of 27 cases of tendinosis and partial rupture [39]. MRI reported a 66% accuracy rate for assessment for tendon subluxation and dislocation [44,45]. MRI evidence of peroneal tendon pathology should be treated with caution because up to 34% of asymptomatic patients may have a tear of the peroneus brevis tendon [49]. One study showed that MRI evidence of peroneal tendon pathology had a 48% positive predictive value for clinical findings, highlighting the importance of clinical examination [50]. Image-guided Anesthetic Injection In addition to the diagnostic capabilities of US, when a tendon abnormality is detected, a fluoroscopic or US- guided intrasheath anesthetic injection can be concurrently performed [11]. Tenography Diagnostic and therapeutic ankle tenography can also be considered for evaluation, with one study reporting that 47% of patients had prolonged relief of symptoms [51]. CT CT is not routinely used for the evaluation of suspected tendon abnormality. Bone Scan Bone scan is not routinely used for the evaluation of suspected tendon abnormality. CT Arthrography CT arthrography is not routinely used for the evaluation of suspected tendon abnormality. MR Arthrography MR arthrography is not routinely used for the evaluation of suspected tendon abnormality. Arthrography Arthrography is not routinely used for the evaluation of suspected tendon abnormality. Chronic Ankle Pain