Accuracy of cone-beam computed tomography for syndesmosis injury diagnosis compared to conventional computed tomography

•Syndesmosis injury can lead to ankle mortise instability and early osteoarthritis.•Different measurements are established for the multiple detector computed tomography but are not yet studied for the weight-bearing cone beam CT.•The syndesmosis instability is actually confirmed via manual testing upon arthroscopic examination, considered as gold standard diagnostic.•MDCT demonstrated better ability to distinguish pathological syndesmosis than WB CBCT, with the antero-posterior fibular translation as best discriminating measurement.•The physiological widening of the contralateral syndesmosis occurring with the WB CBCT upright position may explain these results.