Conventional MRI Versus MR Arthrography in Evaluation of Ankle Impingement Syndromes and Intra Articular Pathologies.

NCT ID: NCT03860922

Last Updated: 2022-08-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-09-10

Study Completion Date

2022-12-30

Brief Summary

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Chronic ankle pain is a common clinical problem with a wide differential diagnosis. Soft-tissue and osseous impingement syndromes are now increasingly recognized as a significant cause of chronic ankle pain. Ankle impingement syndromes are defined as pathologic conditions resulting in chronic, painful restriction to movement at the tibiotalar articulation secondary to soft-tissue or osseous abnormalities. Ankle impingement is classified according to its anatomic relationship to the tibiotalar joint as anterolateral, anterior, anteromedial, posteromedial, or posterior impingement.

Detailed Description

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The anterolateral impingement syndrome is caused by obstruction of the so-called anterolateral gutter (ALG) or recess secondary to an inversion injury resulting in disruption of the syndesmotic and/or lateral collateral ligaments and capsule.

In anterior impingement,Arthroscopic evaluations suggest direct microtrauma to the talus and tibia as the aetiology. The natural course of this microtraumas to form osseous spurs.

In anteromedial impingement,The mechanism is not well understood but is likely a rare complication of a supination (inversion) injury rather than a pronation (eversion) injury as initially hypothesized.During the acute injury, there is damage to the anterior tibiotalar ligament, which subsequently thickens. In addition toligament thickening, osteophytes, synovitis and fractures have been described as other possible causative factors.

In posteromedial impingement, the common precipitating injury for posteromedial ankle impingement is a plantar flexion, inversion and internal rotation trauma. This can lead to damage to the PTTL and associated synovitis.

The majority of the posterior impingement syndromes are related to the posterior talus.The secondary ossification centre of the posterolateral talus forms around 8-13 years of age and then subsequently fuses within 1 year of that. Occasionally (approximately 7%), there may be non-fusion with a resultant ostrigonum.

Conventional MR imaging can accurately detect and localize osteophytes and associated lesions. In addition, MR imaging provides an easy evaluation of any articular cartilage changes, ligamentous injury, and occult bony contusions.

Direct magnetic resonance (MR) arthrography extends the capabilities of conventional MR imaging and utilizes the natural advantages gained from joint effusion. Contrast solution distends the joint capsule, outlines intra articular structures,and leaks into abnormalities.It can detect cartilage damage, intra articular loose bodies and osteochondral talar lesions.

Conditions

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Ankle Impingement Syndrome

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

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Magnetic Resonance Imaging

all patient will undergo Magnetic resonance imaging and magnetic imaging arthrography of the ankle joint.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* patients in different age groups and both sex referred from orthopedic outpatient clinic with chronic ankle pain and suspected clinically to have impingement syndrome.

Exclusion Criteria

1. Inflammatory arthritis of ankle joint, infection in ankle joint, neoplasm around ankle joint.
2. Patients with contraindications for MRI, e.g. an implanted magnetic device, pacemakers or claustrophobia.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Kawsar Abdel Halim Mohamed

principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kawsar Mohamed

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Locations

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Faculty of medicine

Asyut, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Samy Sayed

Role: CONTACT

01006788053

Mohamed Koreim

Role: CONTACT

01003331902

Facility Contacts

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Samy Sayed

Role: primary

01006788053

Role: backup

01003331902

References

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Steinbach LS, Palmer WE, Schweitzer ME. Special focus session. MR arthrography. Radiographics. 2002 Sep-Oct;22(5):1223-46. doi: 10.1148/radiographics.22.5.g02se301223.

Reference Type BACKGROUND
PMID: 12235350 (View on PubMed)

Mosier-La Clair SM, Monroe MT, Manoli A. Medial impingement syndrome of the anterior tibiotalar fascicle of the deltoid ligament on the talus. Foot Ankle Int. 2000 May;21(5):385-91. doi: 10.1177/107110070002100505.

Reference Type RESULT
PMID: 10830656 (View on PubMed)

Robinson P, White LM, Salonen D, Ogilvie-Harris D. Anteromedial impingement of the ankle: using MR arthrography to assess the anteromedial recess. AJR Am J Roentgenol. 2002 Mar;178(3):601-4. doi: 10.2214/ajr.178.3.1780601.

Reference Type RESULT
PMID: 11856682 (View on PubMed)

Donovan A, Rosenberg ZS. Extraarticular lateral hindfoot impingement with posterior tibial tendon tear: MRI correlation. AJR Am J Roentgenol. 2009 Sep;193(3):672-8. doi: 10.2214/AJR.08.2215.

Reference Type RESULT
PMID: 19696280 (View on PubMed)

Murawski CD, Kennedy JG. Anteromedial impingement in the ankle joint: outcomes following arthroscopy. Am J Sports Med. 2010 Oct;38(10):2017-24. doi: 10.1177/0363546510369335. Epub 2010 May 17.

Reference Type RESULT
PMID: 20479141 (View on PubMed)

Giannini S, Buda R, Mosca M, Parma A, Di Caprio F. Posterior ankle impingement. Foot Ankle Int. 2013 Mar;34(3):459-65. doi: 10.1177/1071100713477609.

Reference Type RESULT
PMID: 23520307 (View on PubMed)

Hayashi D, Roemer FW, D'Hooghe P, Guermazi A. Posterior ankle impingement in athletes: Pathogenesis, imaging features and differential diagnoses. Eur J Radiol. 2015 Nov;84(11):2231-41. doi: 10.1016/j.ejrad.2015.07.017. Epub 2015 Jul 17.

Reference Type RESULT
PMID: 26239710 (View on PubMed)

Paterson RS, Brown JN. The posteromedial impingement lesion of the ankle. A series of six cases. Am J Sports Med. 2001 Sep-Oct;29(5):550-7. doi: 10.1177/03635465010290050501.

Reference Type RESULT
PMID: 11573911 (View on PubMed)

Haller J, Bernt R, Seeger T, Weissenback A, Tuchler H, Resnick D. MR-imaging of anterior tibiotalar impingement syndrome: agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography. Eur J Radiol. 2006 Jun;58(3):450-60. doi: 10.1016/j.ejrad.2006.03.008. Epub 2006 Apr 18.

Reference Type RESULT
PMID: 16621392 (View on PubMed)

Robinson P, White LM, Salonen DC, Daniels TR, Ogilvie-Harris D. Anterolateral ankle impingement: mr arthrographic assessment of the anterolateral recess. Radiology. 2001 Oct;221(1):186-90. doi: 10.1148/radiol.2211001666.

Reference Type RESULT
PMID: 11568338 (View on PubMed)

Other Identifiers

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MRAAIS

Identifier Type: -

Identifier Source: org_study_id

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