Kamada Kohei, Hoshino Yuichi, Yamamoto Tetsuya, Kamachi Masamune, Kanzaki Noriyuki, Kuroda Ryosuke
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
University of Pittsburgh Medical Center Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ann Jt. 2024 Oct 29;9:41. doi: 10.21037/aoj-24-31. eCollection 2024.
Diagnosing chronic lateral ankle instability (CLAI) involves a comprehensive evaluation encompassing medical history, physical findings, and imaging examination. The optimal method of diagnosis of CLAI remains controversial. Therefore, the objective of this review was to summarize the current literatures regarding recent evolution and technical improvement of diagnostic methods for CLAI.
A literature regarding the diagnosis of CLAI was reviewed on PubMed, including articles written in English until May 2024.
In the manual examination for the diagnosis of CLAI, the anterior drawer test is the standard evaluation for lateral ligament insufficiency. The anterolateral drawer test, meanwhile, which focuses more on lateral instability biomechanically, has also been performed. Ultrasonography is a point-of-care tool that is less invasive than stress radiography and can dynamically assess ligament integrity, making the diagnosis of CLAI more accurate and convenient. Magnetic resonance imaging (MRI) is a useful modality that allows extensive preoperative evaluation of ligamentous properties and associated osteochondral damage, and it is essential in the preoperative diagnosis of CLAI.
A combination of physical examination and imaging studies is especially important to more accurately diagnose CLAI. Future research should focus on standardizing testing and measurement methods to objectively define CLAI.
诊断慢性外侧踝关节不稳（CLAI）需要综合评估病史、体格检查结果和影像学检查。CLAI的最佳诊断方法仍存在争议。因此，本综述的目的是总结有关CLAI诊断方法近期进展和技术改进的当前文献。
在PubMed上检索有关CLAI诊断的文献，包括截至2024年5月的英文文章。
在CLAI诊断的体格检查中，前抽屉试验是评估外侧韧带损伤的标准方法。同时，更侧重于外侧不稳生物力学的前外侧抽屉试验也已开展。超声检查是一种床旁检查工具，比应力放射照相侵入性小，能够动态评估韧带完整性，使CLAI的诊断更准确、便捷。磁共振成像（MRI）是一种有用的检查方式，可在术前广泛评估韧带特性及相关骨软骨损伤，对CLAI的术前诊断至关重要。
体格检查与影像学检查相结合对于更准确地诊断CLAI尤为重要。未来的研究应聚焦于标准化检测和测量方法，以客观界定CLAI。
