Anterolateral talar palpation: A complementary test for ankle instability

Foot Ankle Surg. 2018 Dec;24(6):486-489. doi: 10.1016/j.fas.2017.05.006. Epub 2017 Jun 6.

Abstract

Background: The anterior drawer test is traditionally used to assess ankle instability, but we believe that there is room for a small but effective improvement by adding digital palpation of the talus. We aimed to determine the accuracy of anterolateral talar palpation (ATP) in the diagnosis of ankle instability by comparing it with the traditional anterior drawer test.

Methods: Fourteen symptomatic and 10 asymptomatic patients were examined for excessive mobility through comparison of both ankles by two blinded orthopedic surgeons, each one using one of the above-mentioned tests. Symptomatic patients were also referred for stress radiography and magnetic resonance imaging (MRI).

Results: ATP was the most sensitive test, but also the least specific, yielding more positive results than the other tests, including tests with negative MRI. ATP and radiography had the highest accuracy and highest level of agreement with MRI.

Conclusions: ATP significantly improved diagnostic accuracy in detecting ankle instability.

Level of evidence: IV: cross-sectional study.

Keywords: Ankle instability; Anterior drawer test; Anterolateral talar palpation; Complementary test.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Ankle Joint* / diagnostic imaging
  • Cross-Sectional Studies
  • Female
  • Humans
  • Joint Instability / diagnosis*
  • Joint Instability / diagnostic imaging
  • Male
  • Palpation / methods*
  • Physical Examination
  • Range of Motion, Articular
  • Reproducibility of Results
  • Single-Blind Method
  • Talus* / diagnostic imaging
  • Young Adult