{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:36:57Z","timestamp":1791337017664,"version":"4.3.1"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To systematically review the literature evaluating whether incorporating ligament thickening and increased signal intensity alongside ligament discontinuity on magnetic resonance imaging (MRI) improves diagnostic accuracy for anterior talofibular ligament (ATFL) injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Two independent reviewers conducted a systematic literature search on the basis of Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses guidelines, using the MEDLINE, Embase, CINAHL Complete, and Scopus databases to find studies reporting MRI and ultrasound imaging findings after ATFL injuries. Statistical analyses were conducted via Review Manager, and a\n                      <jats:italic>P<\/jats:italic>\n                      value of &lt;.05 was statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 15 studies met inclusion criteria, and 9 provided sufficient data for meta\u2010analyses. MRI demonstrated high sensitivity and specificity for diagnosing ATFL injuries. There were greater diagnostic results for ligament thickening with increased signal intensity, but there was no statistically significant difference between diagnostic approaches on the basis solely of ligament discontinuity and the thickening with increased signal intensity. Pooled sensitivity ranged from 84.7% to 87.1%, whereas specificity ranged from 84.6% to 91.4%. Diagnostic odds ratios were consistently high across methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study found that incorporating ligament thickening and increased signal intensity alongside ligament discontinuity on MRI does not significantly improve diagnostic accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, systematic review of Level II and III studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2025.101194","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T11:39:14Z","timestamp":1748864354000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["No Difference in Ligament Discontinuity Versus Thickening on Magnetic Resonance Imaging When Evaluating Anterior Talofibular Ligament Injuries: A Systematic Review"],"prefix":"10.1002","volume":"7","author":[{"given":"Joshua","family":"Taylor","sequence":"first","affiliation":[{"name":"UNC School of Medicine Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damon V.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert T.","family":"Anastasio","sequence":"additional","affiliation":[{"name":"Duke Department of Orthopaedic Surgery Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia E.","family":"Ralph","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Poehlein","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University School of Medicine Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia L.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University School of Medicine Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Hendren","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Lau","sequence":"additional","affiliation":[{"name":"Duke Department of Orthopaedic Surgery Durham North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2007.tb01851.x"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-021-00660-x"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.927920"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200737010-00006"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2021.11.1369"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.351130139"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13142324"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-018-0811-4"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.02.024"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.38.2000295"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2009.12.022"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.03.001"},{"key":"e_1_2_3_14_2","unstructured":"OCEBM Levels of Evidence Working Group\u2217.\u201cThe Oxford Levels of Evidence 2\u201d. 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