Ultrasound-based assessment of talar cartilage in individuals with chronic ankle instability: a systematic review

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.