Arthrography for the diagnosis of acute lateral ligament injuries of the ankle.

Arthrography was used for diagnosis of ruptures of lateral ligaments in 589 acutely injured ankles that were treated operatively. The accuracy of the method was tested comparing the findings of arthrography with those at operation. We found arthrography to be almost 100% reliable for diagnosing a fresh anterior talofibular ligament rupture. The best criterion for detecting calcaneofibular ligament rupture was filling of the peroneal tendon sheath with contrast medium. Leakage below and behind the lateral malleolus, when present with peroneal tendon sheath filling, confirms the diagnosis of calcaneofibular ligament rupture, but these findings without peroneal tendon sheath filling are too rare to base the diagnosis on them alone.