Examining the ankle using X-rays has been standard in the medical world. This method is very accurate for diagnosing bone fractures. Because of the complexity of the ankle structure, several different views on X-rays are usually needed. X-rays are not always able to show damage to the surrounding ligaments. However, with the progress in optical technology, arthroscopic examination of the ankle is now possible.
The arthroscope is a tiny camera that can be inserted into the ankle joint to see if there are any broken bones or torn ligaments. One set of ligaments, called the ankle syndesmosis, joins the two lower leg bones together. X-rays are about 50 to 64 percent accurate in showing if the syndesmosis has been damaged. By comparison, ankle arthroscopy is 100 percent accurate. This new method is sometimes necessary for correct diagnosis of soft tissue damage that occurs with ankle injuries.