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The online version of this article (doi:10.1186/1757-1146-6-7) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
DDR carried out data collection and drafting the manuscript. NCG carried out the literature review and drafting the manuscript. JJM carried out data collection and drafting the manuscript. KF carried out clinical guidance of the study and revising the manuscript. VV carried out the oversight, design, statistical analysis, and the multiple revisions of the manuscript. All authors have read and approved the final manuscript.
The Lisfranc ligament plays an integral role in providing stability to the midfoot. Variable clinical presentations and radiographic findings make injuries to the Lisfranc ligament notoriously difficult to diagnose. Currently, radiographic evaluation is the mainstay in imaging such injuries; however, ultrasound has been suggested as a viable alternative. The objective of this study was to evaluate the intra-rater and inter-rater reliability in the measurement of the length of the dorsal Lisfranc ligament using ultrasound imaging in healthy, asymptomatic subjects.
The dorsal Lisfranc ligaments of fifty asymptomatic subjects (n = 100 feet) were imaged using a Siemens SONOLINE Antares Ultrasound Imaging System© under low, medium, and high stress loads at 0° and 15° abducted foot positions. The lengths of the ligaments were measured, and Interclass correlation coefficients were used to calculate within-session intra-rater reliability (n = 100 feet) as well as between-session intra-rater reliability (n = 40 feet) and between-session inter-rater reliability (n = 40 feet).
The within-session intra-rater reliability results for dorsal Lisfranc ligament length had an average ICC of 0.889 (min 0.873 max 0.913). The average ICC for between-session intra-rater reliability was 0.747 (min 0.607 max 0.811). The average ICC for between-session inter-rater reliability was 0.685 (min 0.638 max 0.776).
The measurement of the dorsal Lisfranc ligament length using ultrasound imaging shows substantial to almost perfect reliability when evaluating asymptomatic subjects. This imaging modality methodology shows promise and lays the foundation for further work in technique development towards the diagnostic identification of pathology within the Lisfranc ligament complex.
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- Reliability of ultrasound imaging in the assessment of the dorsal Lisfranc ligament
David D Rettedal
Nathan C Graves
Joshua J Marshall
- BioMed Central