Evidence map›Paper›PMID 30937585›Full record

ArticleEuropean radiology2019

MRI of ankle sprain: the association between joint effusion and structural injury severity in a large cohort of athletes.

Michel D Crema, Branislav Krivokapic, Ali Guermazi, Predrag Gravilovic, Nebojsa Popovic, Pieter D'Hooghe, Frank W Roemer

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In one paragraph

Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

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  13. MRI of the distal tibiofibular joint.Skeletal radiology · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 5 countries.

Michel D CremaDepartment of Radiology, Hôpital Saint-Antoine, Sorbonne University, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France. michelcrema@gmail.com.ORCID http://orcid.org/0000-0001-8582-0793
Branislav KrivokapicMedical School, University of Belgrade, Belgrade, Serbia.
Ali GuermaziDepartment of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA.
Predrag GravilovicCenter for Medical Informatics, Belgrade, Serbia.
Nebojsa PopovicAspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Pieter D'HoogheAspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Frank W RoemerDepartment of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA.
Boston University · USQatar Orthopaedic and Sports Medicine Hospital · QAUniversity of Belgrade · RS

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo test the hypothesis if presence and amount of effusion in the tibiotalar and talocalcaneal joints are associated with an increased risk for severe structural injury in ankle sprains.

methodsA total of 261 athletes sustaining acute ankle sprains were assessed on MRI for the presence and the amount of joint effusion in the tibiotalar and talocalcaneal joints, as well as for ligamentous and osteochondral injury. Specific patterns of injury severity were defined based on lateral collateral ligament, syndesmotic, and talar osteochondral involvement. The presence and the amount effusion (grades 1 and 2) were considered as risk factors for severe injury, while physiological amount of fluid (grade 0) was considered as the referent. Conditional logistic regression was used to assess the risk for associated severe injuries (syndesmotic ligament rupture and talar osteochondral lesions) based on the presence and amount of tibiotalar and talocalcaneal effusions.

resultsFor ankles exhibiting large (grade 2) effusion in the tibiotalar joint (without concomitant grade 2 effusion in the talocalcaneal joint), the risk for partial or complete syndesmotic ligament rupture was increased more than eightfold (adjusted odds ratio 8.7 (95% confidence intervals 3.7-20.7); p < 0.001). The presence of any degree of effusion in any of the joints was associated with an increased risk for severe talar osteochondral involvement (several odds ratio values reported; p < 0.001), including large subchondral contusions and any acute osteochondral lesion.

conclusionThe presence of tibiotalar and talocalcaneal effusions is associated with an increased risk for severe concomitant structural injury in acute ankle sprains. KEY POINTS: • For ankles exhibiting severe (grade 2) effusion in the tibiotalar joint after sprain, the risk for partial or complete syndesmotic ligament rupture increases more than eightfold. • The presence of effusion in both tibiotalar and talocalcaneal joints is associated with an increased risk for severe ligament injury such as complete ATFL rupture as well as partial or complete syndesmotic ligament rupture. • The presence of effusion in the tibiotalar or talocalcaneal joints after sprain is associated with an increased risk for severe talar osteochondral involvement.

Indexed as

AdolescentAdultAnkle InjuriesAnkle JointAthletic InjuriesCohort StudiesFemaleHumansLogistic ModelsMagnetic Resonance ImagingMaleOdds RatioSprains and StrainsYoung AdultAnkle injuriesMagnetic resonance imagingSprains and strains

Identifiers

PMID30937585
OpenAlexW2928909808

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.