Document Type

Article

Publication Date

2026

DOI

10.1007/s10067-026-08049-3

Publication Title

Clinical Rheumatology

Volume

Advance online publication

Pages

12 pp.

Abstract

Purpose

To systematically synthesize ultrasound (US) evidence on talar cartilage morphology and load-induced deformation in individuals with chronic ankle instability (CAI), and to map methodological approaches (acquisition, outcome definitions, loading paradigms, and normalization) to inform protocol standardization.

Methods

PubMed, Web of Science, and EBSCO were searched (March 31, 2025). Eligible studies reported quantitative US-derived talar cartilage morphology (e.g., thickness, cross-sectional area [CSA]) and/or deformation following standardized loading in CAI and comparison groups. Due to heterogeneity in imaging protocols, loading tasks, and outcome definitions, findings were synthesized narratively and organized by outcome domain.

Results

Across available cohorts, load-induced deformation was the most consistently differentiating signal: CAI groups generally demonstrated greater deformation than controls, with more frequent regional effects at the medial talar dome. Evidence for baseline (unloaded) morphological differences was mixed, with some studies reporting no group differences and others reporting larger CSA in CAI. Associations between deformation and neuromechanical measures (e.g., inversion laxity, postural control, hop biomechanics, ground reaction forces) were reported but were protocol- and cohort-dependent.

Conclusions

Current evidence, limited by few unique cohorts, partial non-independence across publications, and heterogeneous acquisition/loading/normalization procedures, suggests that B-mode US can quantify talar cartilage morphology and detect load-induced deformation differences in CAI in research settings. Talar cartilage ultrasonography should be considered investigational until standardized acquisition and analysis procedures and longitudinal validity are established.

Key Points

• Ultrasound can quantify talar cartilage morphology and load-induced deformation in individuals with chronic ankle instability.

• Load-induced talar cartilage deformation appears to be the most consistent ultrasound-derived feature differentiating chronic ankle instability from healthy controls.

• Evidence for baseline talar cartilage morphology differences is mixed, likely reflecting heterogeneity in cohorts and imaging/loading protocols.

• Standardized acquisition, loading, and analysis methods, along with independent longitudinal validation, are needed before clinical translation.

Rights

© The Authors 2026.

This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original authors and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Data Availability

Article states: "All extracted data (study-level characteristics, outcome summaries) are available from the corresponding author upon reasonable request."

ORCID

0000-0002-8949-9471 (Mohammadi), 0009-0003-5416-7981 (Eshghi), 0000-0003-4052-5023 (Wilson)

Original Publication Citation

Mohammadi, A., Eshghi, S., Mohammadi, I., Wilson, P., & McCann, R. (2026). Ultrasound-based assessment of talar cartilage in individuals with chronic ankle instability: A systematic review. Clinical Rheumatology. Advance online publication. https://doi.org/10.1007/s10067-026-08049-3

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