Staff Members - Benha University
The Added Diagnostic Value of the Bright Rim Sign to Conventional MRI Assessment of Anterior Talofibular Ligament Disruption
Academic Radiology • 2020
Publication Information
Authors
Mohammad Abd Alkhalik Basha, MD, Diaa Bakry Eldib, MD, Mohamed M.A. Zaitoun, MD,
Tarek Mohamed Ghandour, MD, Tarek Aly, MD, Shimaa Mostafa, MD, Doaa S. Atta, MD,
Hesham Youssef Algazzar, MD
Keywords
Key Words: Magnetic resonance imaging; Bright rim sign; Anterior talofibular ligament; Ankle sprain.
Journal
Academic Radiology
Publisher
Elsevier
Volume
Not Available
Issue
Not Available
Pages
1-11
publication.type
International
Paper Link
Not Available
Supplementary Materials
Not Available
Abstract
Rationale and Objectives: The bright rim sign (BRS) was used as a reliable indicator of anterior talofibular ligament (ATFL) disruption
beside other well-known diagnostic criteria. Although this sign can improve accuracy of conventional magnetic resonance imaging (MRI)
in diagnosis of ATFL disruption, it was not adequately discussed in the literature. This study aimed to confirm the added diagnostic value
of BRS to conventional MRI assessment of ATFL disruption.
Materials and Methods: A prospective study included 62 patients (47 males and 15 females; mean age, 36.9 § 12.1 years; range, 1752
years) with clinically suspected ATFL disruption. All patients underwent MRI and arthroscopy of ankle. MRI images were evaluated for the
presence of ligament disruption sign (LDS) and BRS. The patients were classified into 3 groups: group 1 included patients with acute lateral
ankle ligament sprain; group 2 included patients with chronic ankle instability; and group 3 included patients with recurring ankle
sprain. The diagnostic value of the BRS was evaluated using arthroscopy as reference standard.
Results: The diagnostic value of both signs together increased overall sensitivity in detecting ATFL disruption to 86.7% compared to 60%
when considering LDS alone (p < 0.0001). In group 1 and 3, the sensitivity increased when both signs were considered together compared
to LDS alone (p = 0.004 and 0.025, respectively). In group 2, there was a trend toward significance in sensitivity when both signs were considered
compared to LDS alone (p = 0.08).
Conclusion: BRS is a very helpful diagnostic sign in assessment of ATFL disruption when considered conjointly with the LDS.
beside other well-known diagnostic criteria. Although this sign can improve accuracy of conventional magnetic resonance imaging (MRI)
in diagnosis of ATFL disruption, it was not adequately discussed in the literature. This study aimed to confirm the added diagnostic value
of BRS to conventional MRI assessment of ATFL disruption.
Materials and Methods: A prospective study included 62 patients (47 males and 15 females; mean age, 36.9 § 12.1 years; range, 1752
years) with clinically suspected ATFL disruption. All patients underwent MRI and arthroscopy of ankle. MRI images were evaluated for the
presence of ligament disruption sign (LDS) and BRS. The patients were classified into 3 groups: group 1 included patients with acute lateral
ankle ligament sprain; group 2 included patients with chronic ankle instability; and group 3 included patients with recurring ankle
sprain. The diagnostic value of the BRS was evaluated using arthroscopy as reference standard.
Results: The diagnostic value of both signs together increased overall sensitivity in detecting ATFL disruption to 86.7% compared to 60%
when considering LDS alone (p < 0.0001). In group 1 and 3, the sensitivity increased when both signs were considered together compared
to LDS alone (p = 0.004 and 0.025, respectively). In group 2, there was a trend toward significance in sensitivity when both signs were considered
compared to LDS alone (p = 0.08).
Conclusion: BRS is a very helpful diagnostic sign in assessment of ATFL disruption when considered conjointly with the LDS.