Medial clear space (ankle)
Updates to Article Attributes
The medial clear space (MCS) is a radiographic measuremeasurement that may be useful in the diagnosis of ankle instability, syndesmotic injuries and ankle fractures 1-35.
Usage
ItThe medial clear space is used in the prediction of deltoid ligament injury 1 and in conjunction with the tibiofibular clear space (TFCS) the the tibiofibular overlap (TFO) and and the superior clear space in the diagnosis of syndesmotic injury 2,3.
Measurement
The broadestmedial clear space can be measured on the non-stressed and stressed ankle mortise views 2,5, as the widest distance between the lateral border of the medial malleolus and the medial side of the talar dometalus and is usually measured usually parallel to the superior talar articular surface 1-3. This can be measured at the level of the talar dome (common) or 5 mm inferior to the talar dome 2,5.
Interpretation
The medial clear space a horizontal distance of >4≥4-5 mm has been considered abnormal 1-4 although there is criticism that the measurement is inaccurate and imprecise 2,6. There is apparently a difference between male and female and regarding height, which should be taken into account when indicating a diagnosis 4.
See also
-<p>The <strong>medial clear space (MCS) </strong>is a radiographic measure and is defined as the space between the lateral edge of the medial malleolus and the medial side of the <a href="/articles/talus">talus</a> <sup>1-3</sup>.</p><h4>Usage</h4><p>It is used in the prediction of <a href="/articles/deltoid-ligament-injury">deltoid ligament injury</a> <sup>1</sup> and conjunction with the <a href="/articles/tibiofibular-clear-space">tibiofibular clear space (TFCS)</a> the <a href="/articles/tibiofibular-overlap">tibiofibular overlap (TFO)</a> and the superior clear space in the diagnosis <a href="/articles/distal-tibiofibular-syndesmosis-injury">syndesmotic injury</a> <sup>2,3</sup>.</p><h4>Measurement</h4><p>The broadest distance between the lateral border of the medial malleolus and the medial side of the talar dome is measured usually parallel to the superior articular surface <sup>1-3</sup>.</p><h4>Interpretation</h4><p>The medial clear space a horizontal distance of >4-5 mm has been considered abnormal <sup>1-4</sup>. There is apparently a difference between male and female and regarding height, which should be taken into account when indicating a diagnosis <sup>4</sup>.</p><h4>See also</h4><ul>- +<p>The <strong>medial clear space </strong>is a radiographic measurement that may be useful in the diagnosis of <a href="/articles/chronic-ankle-instability">ankle instability</a>, <a href="/articles/distal-tibiofibular-syndesmosis-injury">syndesmotic injuries</a> and <a href="/articles/ankle-fractures-1">ankle fractures</a> <sup>5</sup>.</p><h4>Usage</h4><p>The medial clear space is used in the prediction of <a href="/articles/deltoid-ligament-injury">deltoid ligament injury</a> <sup>1</sup> and in conjunction with the <a href="/articles/tibiofibular-clear-space">tibiofibular clear space</a> the <a href="/articles/tibiofibular-overlap">tibiofibular overlap</a> and the superior clear space in the diagnosis of <a href="/articles/distal-tibiofibular-syndesmosis-injury">syndesmotic injury</a> <sup>2,3</sup>.</p><h4>Measurement</h4><p>The medial clear space can be measured on the non-stressed and stressed ankle mortise views <sup>2,5</sup>, as the widest distance between the lateral border of the medial malleolus and the medial side of the talus and is usually measured parallel to the superior talar articular surface <sup>1-3</sup>. This can be measured at the level of the talar dome (common) or 5 mm inferior to the talar dome <sup>2,5</sup>.</p><h4>Interpretation</h4><p>The medial clear space a horizontal distance of ≥4-5 mm has been considered abnormal <sup>1-4</sup> although there is criticism that the measurement is inaccurate and imprecise <sup>2,6</sup>. There is apparently a difference between male and female and regarding height, which should be taken into account when indicating a diagnosis <sup>4</sup>.</p><h4>See also</h4><ul>
References changed:
- 1. Nielson J, Gardner M, Peterson M et al. Radiographic Measurements Do Not Predict Syndesmotic Injury in Ankle Fractures: An MRI Study. Clin Orthop Relat Res. 2005;&NA;(436):216-21. <a href="https://doi.org/10.1097/01.blo.0000161090.86162.19">doi:10.1097/01.blo.0000161090.86162.19</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/15995444">Pubmed</a>
- 5. Lau B, Allahabadi S, Palanca A, Oji D. Understanding Radiographic Measurements Used in Foot and Ankle Surgery. J Am Acad Orthop Surg. 2021;30(2):e139-54. <a href="https://doi.org/10.5435/jaaos-d-20-00189">doi:10.5435/jaaos-d-20-00189</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/34768261">Pubmed</a>
- 6. Metitiri O, Ghorbanhoseini M, Zurakowski D, Hochman M, Nazarian A, Kwon J. Accuracy and Measurement Error of the Medial Clear Space of the Ankle. Foot Ankle Int. 2016;38(4):443-51. <a href="https://doi.org/10.1177/1071100716681140">doi:10.1177/1071100716681140</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27903794">Pubmed</a>
- 1. Nielson J, Gardner M, Peterson M et al. Radiographic Measurements Do Not Predict Syndesmotic Injury in Ankle Fractures. Clin Orthop Relat Res. 2005;&NA;(436):216-21. <a href="https://doi.org/10.1097/01.blo.0000161090.86162.19">doi:10.1097/01.blo.0000161090.86162.19</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/15995444">Pubmed</a>
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