Ankle arthrography allows radiologists to assess accurately the degree of damage caused by ankle sprains. Ankle sprains are a significant problem to a large number of people, particularly those who participate in sports. Proper care of these ankle injuries requires the combined expertise of many disciplines. Radiologists should be aware of the significance of these lesions and utilize all modalities, including plain films, stress films, and ankle arthrograms, when indicated, to obtain the exact pathologic diagnosis of severe sprains. The primary role of arthrography is to separate those patients who have moderate or severe sprains that may require surgery from those who will respond to more conservative therapy. Many orthopedists believe that combined lateral ligament tears, or any tear involving the deltoid ligament and perhaps the interosseous ligament, may require surgery. At the other end of the spectrum of ankle sprains, occasionally, one may not be able to distinguish between a very slight sprain and a more severe sprain with rupture of the ankle ligament. This is an important distinction, particularly in young athletes who would like to continue to play a competitive sport despite their injury. Utilizing arthrography, the orthopedic surgeon can suggest a more accurate prognosis as to whether the patient might be able to participate with proper taping. Obviously, if the patient has ruptured a ligament, it is not in the best interest of the patient to participate in a competitive sport without allowing a proper interval for healing. I heartily recommend arthrography of the ankle to any radiologist who is not yet utilizing this procedure. I believe that it can add significantly to the care of those patients who sustain ankle sprains.
