To determine the diagnostic value of injury history, clinical findings, syndesmosis tests, and overall clinical suspicion for detecting syndesmotic involvement in athletes with acute ankle injuries, emphasizing the role of clinical suspicion.
Key Findings:
Syndesmosis injuries are difficult to diagnose, with reported sensitivities ranging from 14% to 56% and specificities from 48% to 83%, derived from different studies.
Tenderness of the anterior syndesmosis showed the highest sensitivity (92%) and the squeeze test the highest specificity (88%) in a cohort of athletes.
The timing of physical examination and the pre-test probability may influence diagnostic values.
Interpretation:
In the acute setting, clinical evaluation, including injury history and physical examination, can effectively identify syndesmosis injuries in athletes, highlighting its implications for clinical practice.
Limitations:
No calibration session for physicians prior to the study may affect consistency in test administration.
The study's findings may not be generalizable beyond the specific cohort of athletes assessed, and potential biases in participant selection should be considered.
Conclusion:
Acute clinical evaluation demonstrates high diagnostic value for syndesmosis injuries, supporting the use of clinical tests and overall suspicion in athletic populations, while further research is warranted.
by Thomas P. A. Baltes, Omar Al Sayrafi, Javier Arnáiz, Maryam R. Al-Naimi, Celeste Geertsema, Liesel Geertsema, Louis Holtzhausen, Pieter D’Hooghe, Gino M. M. J. Kerkhoffs, Johannes L. Tol
Researchers compare personalized versus standard prehabilitation and examine functional, immune, and postoperative outcomes before major elective surgery.
