This study protocol was approved by the Catholic Kwandong Medical University Hospital Institutional Review Board. We reviewed the charts of patients who had visited the orthopedic ankle clinic with lateral ankle and foot pain from November 2016 to January 2019 and had undergone A-MRI within 6 months of the visit.

In order to meet the inclusion criteria for the AI group, patients must have: (I) had a history of lateral ankle sprain with persistent symptoms of AI, a positive anterior drawer test, and received non-operative treatment for at least 4 months; (II) experienced AI, pain, and buckling in those 4 months; and (III) no evidence of acute lower-limb or brain injury. Patients were excluded from this study if they met any of the following criteria: (I) peroneal pathology; (II) history of ankle surgery; (III) plantar fasciitis; (IV) neuromuscular atrophic disease; (V) hindfoot varus; or (VI) functional instability.

There were a total of 26 participants in the AI group; 17 (65.38%) were male, and 9 (34.62%) were female, with a mean age of 36.00±11.39 years (20–57 years) (Table 1). To contrast the CFLT and CFLCSA between subjects with and without AI, we recruited a normal control group comprised of participants with ankle and foot pain who wished to undergo A-MRI for an accurate diagnosis. There were no abnormal findings on A-MRI in the normal group.

AI, ankle instability; CFLT, calcaneofibular ligament thickness; CFLCSA, calcaneofibular ligament cross-sectional area; NS, not statistically significant (P>0.05).

In the normal group, 25 participants (13 men and 12 women) were enrolled, with an average age of 37.92±13.68 years (20–67 years).

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