Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle

J Bone Joint Surg Br. 2003 Apr;85(3):324-9. doi: 10.1302/0301-620x.85b3.13174.


In 52 patients we compared the accuracy of standard anteroposterior (AP) radiography, mortise radiography and MRI with arthroscopy of the ankle for the diagnosis of a tear of the tibiofibular syndesmosis. In comparison with arthroscopy, the sensitivity, specificity and accuracy were 44.1%, 100% and 63.5% for standard AP radiography and 58.3%, 100% and 71.2% for mortise radiography. For MRI they were 100%, 93.1% and 96.2% for a tear of the anterior inferior tibiofibular ligament and 100%, 100% and 100% for a tear of the posterior inferior tibiofibular ligament. Standard AP and mortise radiography did not always provide a correct diagnosis. MRI was useful although there were two-false positive cases. We suggest that arthroscopy of the ankle is indispensable for the accurate diagnosis of a tear of the tibiofibular syndesmosis.

Publication types

  • Comparative Study
  • Duplicate Publication

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ankle Joint*
  • Arthroscopy*
  • Child
  • False Positive Reactions
  • Female
  • Humans
  • Ligaments, Articular / diagnostic imaging
  • Ligaments, Articular / injuries*
  • Ligaments, Articular / pathology*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Radiography