Clinical Report: Ultrasound Evaluation of Talar Cartilage in Chronic Ankle Instability
Overview
This systematic review synthesizes evidence on ultrasound (US) assessment of talar cartilage morphology and deformation in patients with chronic ankle instability (CAI). Findings highlight US as a reliable, cost-effective modality correlating with functional outcomes and capable of detecting cartilage changes associated with CAI.
Background
Acute lateral ankle sprains (LAS) are common injuries that can lead to chronic ankle instability (CAI), characterized by mechanical laxity and joint degeneration. Repeated LAS episodes impose mechanical stress on talar cartilage, accelerating degenerative changes and increasing risk of post-traumatic osteoarthritis. While MRI is the standard for cartilage evaluation, ultrasonography offers a noninvasive, accessible alternative with demonstrated reliability for assessing talar cartilage thickness and morphology. This review focuses on US-based evaluation of the tibiotalar articular cartilage in CAI populations.
Data Highlights
The review included observational and interventional studies assessing US measures such as talar cartilage thickness, cross-sectional area, deformation under mechanical loading, echointensity, and echogenicity. Reliability metrics reported include excellent test–retest reliability and interrater reliability with intraclass correlation coefficients (ICCs) ranging from 0.92 to 0.97. Correlations between US and MRI cartilage thickness measurements were strong (r = 0.87–0.93), supporting US feasibility.
Key Findings
Ultrasound reliably measures talar cartilage thickness and morphology in CAI patients, with excellent test–retest and interrater reliability.
US-derived cartilage thickness correlates strongly with MRI measurements, validating its clinical utility.
Individuals with CAI exhibit morphological alterations and altered deformation responses of talar cartilage under mechanical loading compared to controls.
US measures of talar cartilage health are associated with functional outcomes such as postural control and joint mechanics.
Medial talar dome cartilage is particularly susceptible to degenerative changes in CAI due to concentrated joint stress.
Clinical Implications
Ultrasound offers a practical, cost-effective imaging modality for routine assessment of talar cartilage health in patients with chronic ankle instability. Its ability to detect early cartilage alterations and correlate with functional impairments supports its use in monitoring disease progression and guiding rehabilitation strategies. Clinicians may consider incorporating US evaluations to identify patients at risk for post-traumatic osteoarthritis and tailor interventions accordingly.
Conclusion
Ultrasound is a valid and reliable tool for assessing talar cartilage morphology and deformation in chronic ankle instability, providing valuable insights into cartilage health and functional status. Its accessibility and correlation with MRI and clinical outcomes underscore its translational potential in managing CAI.
References
Systematic Review Authors/2025 -- Evaluation of Talar Cartilage via Ultrasound in Patients with Chronic Ankle Instability
