osteochondral lesion talus radiology

This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. Arthroscopic evaluation of the cartilage is regarded as the gold standard [2], but due to its invasiveness and the need for anesthesia, it should be reserved for preoperatively well-documented cases and combined with surgical treatment procedures. 2006;187 (5): 1332-7. 2003; 19(4): 353–9. Diagram shows the classic four signs of instability in an OCD lesion: 1, high signal intensity rim at the interface between the fragment and the adjacent bone on T2-weighted MR images; 2, fluid-filled cysts beneath the lesion; 3, a high-signal-intensity line extending through the articular cartilage overlying the lesion; and 4, a focal osteochondral defect filled with joint fluid. Morrison, et al.Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. 22 (4): 765-74. Cone Beam Computed Tomography (CBCT) arthrography is better suited for precise staging of cartilage lesions. Osteonecrosis can develop when the lesion’s vascularity is disrupted. The purpose of this study was to directly compare the MRI with the arthroscopic findings. We studied the value of MR imaging in determining the stability of the osteochondral fragments. Alternative diagnosis on CBCT compared to MRI. Moreover, despite several modifications of the staging systems on MRI, not all combination of the degree of involvement of the cartilage and subchondral bone are included and therefore these classification systems remain uncomprehensive, complicated and less valuable for use in daily routine. Osteochondral defects of the talus (OCD) are a well-established pathology within the ankle. Coronal reformatted CBCT-A (c) barely shows subtle subchondral sclerosis at the superolateral aspect of the talar dome and intact overlying cartilage. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":1795,"mcqUrl":"https://radiopaedia.org/articles/osteochondral-defect/questions/571?lang=us"}. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by … Contributed by Dr. Hemilianna Hadassa Silva Matozinho M.D. J Bone Joint Surg Am. Osteochondral lesions of the talus are relatively uncommon but may be a cause of significant pain and disability in symptomatic patients. Due to the widespread use of fluid-sensitive sequences on MRI, even subtle foci of BME may be seen adjacent to a cartilage defect, particularly in acute or subacute OCL lesions. Anatomy of the talocrural joint. However, they are insensitive to grading lower stage lesions and are inadequate in predicting stability. A modified grading system has been proposed by Hepple in 1999 [5] and by Dipaola et al. Osteochondral lesions ... radiology, and sports medicine literature. Retrograde drilling of osteochondral lesions of the medial talar dome. Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. CBCT-Arthrography (CBCT-A) of the talocrural joint, coronal reformatted image (d) showing smooth cartilage lining covering the normal subchondral bone of the talus (arrow) and tibia (arrowhead). Characterizing osteochondral lesions by magnetic resonance imaging. The majority of those lesions occur in active patients and are related to trauma. Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Longtemps, leur terminologie fut confuse et l’étiopathogénie est restée un sujet controversé. Knee Surg Sports Traumatol Arthrosc. A… In 10 cadavers and four patients, accuracy of pin placement was in the range of 1.0–3.5 mm. “Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT”. Osteochondral Lesions of the Talus Sara Lyn Miniaci-Coxhead, MD Dr. Miniaci-Coxhead or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. 2 of 7 Posadzy et al: Staging of Osteochondral Lesions of the Talus Figure 1: Location of the OCL according to the mechanism of trauma. 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