Abstract
Objective
To assess the frequency and morphometric characteristics of AALTF on pediatric ankle MRI, its associations with the Gissane angle and subtalar abnormalities, and the incremental value of zero-echo-time (ZTE) imaging for detecting tarsal coalitions.Materials and methods
We retrospectively reviewed ankle MRI examinations of patients aged 0-18 years performed between September 2022 and January 2026. We randomly selected one ankle from each patient with bilateral examinations. Two pediatric radiologists independently assessed AALTF. For comparative analyses, 129 AALTF-negative controls were selected by simple random sampling from 712 AALTF-negative examinations. We performed age-stratified comparisons and age- and sex-adjusted multivariable regression analysis of the Gissane angle.Results
Among 841 patients, 129 (15.3%) had AALTF. Mean facet length was 6.36 ± 2.20 mm, and cartilage coverage was present in 62.0%. The Gissane angle was lower in patients with AALTF than in controls (109.66° ± 6.74° vs. 117.43° ± 8.21°; p Conclusion
AALTF is relatively common on pediatric ankle MRI and is independently associated with a lower Gissane angle and several concomitant abnormalities. A Gissane angle ≤ 112.5° may prompt closer evaluation for AALTF.