Foot and ankle clinics
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A review of the literature reveals that all studies have been performed retrospectively. These studies have included limited numbers of low-grade lesions and no prospective, randomized, comparison studies have been performed to suggest the superiority of CT scanning over MR imaging. The following conclusions, however, can be made. ⋯ This study provides information regarding soft-tissue impingement, proliferative synovitis, and other bony and soft-tissue pathology. The authors have found that despite the results of bone scintigraphy, an MR image is invariably obtained. Because of this the authors do not recommend bone scintigraphy in the evaluation and diagnosis of OLT.
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Although stress radiography has proven helpful in the past with regards to our understanding of mechanisms of injury and subsequent treatment, difficulty persists in defining consistent criteria for stress radiography of the foot and ankle. Until these have been clearly determined or proven, their validity and applicability in helping the physician arrive at a treatment decision may be questioned. It seems that a careful history, physical examination, and critical interpretation of routine radiographs may be most effective. Stress radiographs may be indicated in the elite athlete as a gauge for the severity of injury and rehabilitation course or in preoperative planning for ankle reconstruction when subtalar instability is a consideration.