Suzanne Caroline Shine MBBCh, Presenter: Nothing to Disclose

Darra Thomas Murphy MRCPI, Abstract Co-Author: Nothing to Disclose

Stephen John Eustace MD, Abstract Co-Author: Nothing to Disclose

To describe the incidence, pattern and clinical significance of bone bruising identified at MRI ankle following acute ankle inversion injury.

A retrospective review of 45 patients, who underwent MRI of ankle within 2 weeks of acute ankle inversion injury, was performed. The presence and distribution of bone bruising was recorded in addition to associated features (lateral collateral ligament tear, joint effusion, soft tissue swelling). Assessment was made of the clinical impact of the injury.  

Of 45 patients, 26 displayed bone bruising (58%) at the inner margin of the talus and the congruent surface of the medial malleolus. 37 patients (82%) had tears of the anterior talofibular (ATF) ligament on MRI. The incidence of ATF ligament tear was 92% where bone bruising was present and 68% where it was absent. Mean time required to return to sports activity was 7 days for those without bone bruising versus 50 days for those with bone bruising. Medial ankle joint pain persisting beyond 2 months post-injury occurred in 38% patients with bone bruising vs. 0% patients without.

Bone bruising of the inner margin of the talus and the congruent surface of the medial malleolus frequently occurs following inversion ankle injuries. When present in this study, it was frequently associated with tear of the ATF (92%), delayed recovery and persistent medial joint pain. Identification of this bone bruise pattern on MRI should prompt close scrutiny to determine the ATF ligament integrity.

The presence of this bone bruise pattern (inner margin of talus and congruent surface of medial malleolus) should prompt close examination of lateral collateral ligament integrity.

Shine, S, Murphy, D, Eustace, S, Bone Bruise Pattern Complicating Ankle Inversion Injury at Magnetic Resonance Imaging.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6018378.html