Wikstrom Erik A, Jang Jaeho, Pietrosimone Brian, Franz Jason R, Nissman Daniel B, Lin Feng-Chang
Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Department of Kinesiology, University of Texas at El Paso, El Paso, USA.
Clin Rheumatol. 2025 Sep 16. doi: 10.1007/s10067-025-07680-w.
INTRODUCTION/OBJECTIVES: Chronic ankle instability (CAI) is a significant contributor to articular degeneration at the ankle. Identifying early pathogenic articular changes is limited to compositional MRI techniques which are not clinically feasible. Ultrasound is cost-effective, and echo-intensity (EI) measures may be an indicator of cartilage health. Therefore, we aimed to (i) quantify changes in ultrasound measures of talar cross-sectional area (CSA) and EI following standardized loading protocols and recovery periods and (ii) quantify the associations between ultrasound measures and talar and subtalar cartilage composition in those with CAI.
Thirty-seven individuals with CAI (22.6 ± 4.2 years, 3.8 ± 2.7 sprains) completed a T1ρ MRI and two ultrasound assessments. The talar cartilage was imaged with US before, immediately after, 15-min after, and 30-min after separate static and dynamic loading protocols.
Ultrasound outcomes acutely changed in response to load (p < 0.05). The CSA and EI means remained altered throughout the recovery period (p < 0.05) while the EI standard deviation recovered to baseline levels. Greater subtalar T1ρ relaxation times (i.e., worse composition) were significantly (p ≤ 0.05) associated with lower thickness (r = -0.409) and EI variability (r = 0.419) baseline values, greater EI mean responses to load (r = -0.558), and smaller EI mean recoveries (r ≥ -0.360) which all suggest worse cartilage health.
In those with CAI, ultrasound-based outcomes acutely respond to load but have unique recovery patterns. Ultrasound may serve as a valid clinically accessible tool to evaluate ankle cartilage composition, particularly Subtalar cartilage. Key Points • In those with CAI, talar cartilage CSA and EI, measured via ultrasound, are acutely sensitive to load but recovery patterns are outcome specific. • Ultrasound measures of thickness and EI may serve as valid clinically accessible surrogates of subtalar cartilage composition.
引言/目的：慢性踝关节不稳（CAI）是踝关节关节退变的一个重要因素。识别早期致病性关节变化仅限于成分MRI技术，而这些技术在临床上不可行。超声具有成本效益，且回声强度（EI）测量可能是软骨健康的一个指标。因此，我们旨在（i）量化标准化负荷方案和恢复期后距骨横截面积（CSA）和EI的超声测量变化，以及（ii）量化CAI患者超声测量与距骨和距下关节软骨成分之间的关联。
37名CAI患者（22.6±4.2岁，3.8±2.7次扭伤）完成了T1ρ MRI和两次超声评估。在单独的静态和动态负荷方案之前、之后立即、之后15分钟和之后30分钟，用超声对距骨软骨进行成像。
超声结果对负荷有急性变化（p<0.05）。在整个恢复期，CSA和EI平均值保持改变（p<0.05），而EI标准差恢复到基线水平。距下关节T1ρ弛豫时间越长（即成分越差）与较低的厚度（r=-0.409）和EI变异性（r=0.419）基线值、更大的EI对负荷的平均反应（r=-0.558）以及更小的EI平均恢复（r≥-0.360）显著相关（p≤0.05），所有这些都表明软骨健康状况较差。
在CAI患者中，基于超声的结果对负荷有急性反应，但有独特的恢复模式。超声可作为一种有效的临床可用工具来评估踝关节软骨成分，特别是距下关节软骨。要点•在CAI患者中，通过超声测量的距骨软骨CSA和EI对负荷急性敏感，但恢复模式因结果而异。•厚度和EI的超声测量可作为距下关节软骨成分有效的临床可用替代指标。
