Cheongju ankle sprain, why it should be accurately confirmed with ultrasound — Cheongju Seowon-gu pain medicine clinic
Author: Chief Director Kim Young-moo (Anesthesiology and Pain Medicine Specialist, Pain Medicine Fellow)
This content has been written in compliance with applicable laws including the Medical Service Act.
Many people think that after spraining their ankle, "a few days of rest will make it fine." However, if the pain persists for more than a week or you repeatedly sprain the same area, the situation is different. The first step to distinguishing between simple contusion and ligament damage is ultrasound diagnosis.
If you sprained your ankle in Cheongju, ultrasound diagnosis comes first
When patients visit the hospital shortly after spraining their ankle, X-ray (plain radiography) imaging is usually performed first. However, X-rays are specialized for examining bone structures, making it difficult to identify damage to soft tissues such as ligaments or tendons. According to the National Health Insurance Service Non-covered Information Portal, ultrasound examination can precisely assess soft tissue damage without radiation exposure.
In other words, ultrasound examination is necessary to properly understand the condition of ligaments and tendons after an ankle sprain.
However, if fracture is suspected, additional X-ray or CT imaging may be necessary. Additionally, according to a 2023 paper in the Journal of Korean Orthopaedic Association (J Korean Orthop Assoc), osteochondral lesions (OLT) and other deep joint structures may require CT or MRI imaging due to limitations in ultrasound access. Ultrasound has strengths in diagnosing superficial soft tissue, and it is good to consult with a specialist about whether additional imaging is needed based on the examination results.
Simple Q&A
Q. If the ankle doesn't swell much, is the ligament okay?
It is difficult to determine whether ligaments are damaged based on the degree of swelling alone. Even mild swelling can be accompanied by partial ligament tears, so if pain persists, it is recommended to directly confirm with ultrasound examination.
Ankle ligament injury, why ultrasound is necessary
| Examination Method | Confirming Structures | Characteristics |
|---|---|---|
| X-ray (plain radiography) | Bone structure, presence of fracture | Difficulty in directly confirming soft tissue damage |
| Ultrasound | Ligaments, tendons, soft tissues | Real-time and dynamic examination possible, no radiation exposure |
| MRI | Ligaments, tendons, osteochondral lesions, deep structures | High precision but high cost and time-consuming |
| CT | Bone and joint structure, osteochondral lesions | Radiation exposure, precise confirmation of bony structures |
According to a 2023 paper in the Journal of Korean Orthopaedic Association (J Korean Orthop Assoc), ligament injury is accompanied in approximately 85% of acute ankle injuries, with anterior talofibular ligament (ATFL) injury being the most common. Ankle ligaments are located in superficial layers close to the skin, so real-time observation with ultrasound is possible, and through dynamic imaging while moving the ankle, differential diagnosis of ligament instability and microtrauma can be performed, as reported in clinical data.
If simple sprain is diagnosed and left untreated, clinical cases show that approximately 40% can progress to chronic ankle instability (CAI). Precisely identifying the extent of initial damage and providing appropriate treatment is key to preventing chronicity.
Responses may vary depending on individual constitution and symptom severity.
Asanwell pain clinic's ultrasound-guided diagnosis and treatment approach
According to the Korean Society of Ultrasound in Medicine, musculoskeletal ultrasound is a useful examination method for closely examining large and small joints including the ankle and foot, as well as ligament condition. In particular, when conducting injection therapy under ultrasound guidance, real-time confirmation of accurate injection location and depth during the procedure is possible, as reported in clinical data.
At Asanwell pain clinic, Chief Director Kim Young-moo, an anesthesiology and pain medicine specialist with fellowship training in pain medicine at Seoul Asan Medical Center and holder of APCA RMSK (American musculoskeletal ultrasound certification), personally operates the ultrasound and confirms ligament and tendon status in real-time.
The flow from diagnosis to treatment is as follows:
▪ Step 1 — Precision ultrasound examination: Real-time ultrasound imaging confirms the status of ankle ligaments, tendons, and soft tissues.
▪ Step 2 — Classification of injury severity: Treatment direction is determined based on whether there is partial ligament tear, complete tear, or tendon damage.
▪ Step 3 — Application of non-surgical treatment: Non-surgical treatments such as ultrasound-guided injection therapy and extracorporeal shock wave therapy (ESWT) are applied in stages depending on the location of damage.
▪ Step 4 — Progress monitoring: Recovery progress is monitored after treatment and the need for additional treatment is reviewed.
Treatment progress may vary depending on the severity of injury and individual circumstances.
Things you must check before procedure
If any of the following items apply after an ankle sprain, it is good to receive consultation from a specialist.
▪ Swelling and tenderness persist for more than a week
▪ The ankle feels unstable when walking or climbing stairs
▪ You have experienced repeated ankle sprains
▪ There is severe tenderness at a specific point when pressing the outer or front of the ankle
▪ Bruising has spread widely around the ankle
▪ Numbness or sensory abnormality in the foot or toes is present
According to a 2025 paper in the Journal of Korean Orthopaedic Association (ultrasound-guided injection therapy for foot and ankle), concomitant injuries such as superficial peroneal nerve damage can occur with ankle sprain, making physical examination important. Severance Hospital health information reports that the incidence of chronic ankle instability is approximately 20% after sprain, with persistent pain, swelling, and repeated sprains lasting 12 months or longer as key characteristics.
For those residing in the Cheongju Heungdeok-gu, Cheongju Cheongwon-gu, Ochang, Osong, and Sejong areas, if ankle pain persists, it is recommended to first undergo precision ultrasound examination.
We provide step-by-step consultation from the beginning
At Asanwell pain clinic, we provide step-by-step consultation from the initial diagnosis of ankle sprain through treatment planning.
As emphasized in clinical information from Korea University Ansan Hospital's Orthopedic Department, early accurate diagnosis and treatment of ankle injury is key to preventing progression to chronic ankle instability and arthritis. If pain does not improve after a few days, it is a wise choice to first check the condition with ultrasound rather than waiting indefinitely.
At Asanwell pain clinic in Bunyeong-dong, Seowon-gu, Cheongju, we work together on a direction suited to your condition, from ultrasound-guided diagnosis through non-surgical treatment planning.
Q&A
Q1. I twisted my ankle, but if I can walk, can I just leave it?
Being able to walk does not mean there is no ligament damage. In many cases, walking is possible even with partial ligament tears, and leaving it untreated can lead to chronic instability. If pain or instability persists for more than a week, it is recommended to confirm the condition with ultrasound examination.
Q2. For ankle ultrasound and MRI, which examination is more necessary?
The two examinations serve different purposes. Ultrasound is advantageous for real-time and dynamic examination of superficial soft tissues such as ligaments and tendons, while MRI is necessary when precisely assessing osteochondral lesions or deep structures. In the early stage of ankle sprain, it is often the case to first confirm ligament damage with ultrasound, then decide on additional testing if necessary.
Q3. For ankle ligament injury, what can ultrasound confirm?
Partial tear, complete tear of the anterior talofibular ligament and posterior talofibular ligament and other lateral ankle ligaments, ligament instability, soft tissue edema, and other conditions can be confirmed in real-time. However, deep structures within the joint such as osteochondral lesions (OLT) have limitations in ultrasound access, and MRI examination may be necessary if such findings are suspected.
Q4. When is ultrasound-guided injection therapy necessary after ankle sprain?
Ultrasound-guided injection therapy can be considered when partial ligament tear or tendon damage causes persistent pain and swelling, or when inflammation is severe and conservative treatment alone shows slow improvement. The indications for treatment are determined by a specialist based on ultrasound examination results and symptoms, so it is best to receive consultation first.
Responses may vary depending on individual constitution and symptom severity