Nowadays MR staging of OCL on MRI is usually done by the Anderson classification [9], which is another modification of the initial staging system based on plain film evaluation by Berndt and Harty (Figure 6). 1989; 71(8): 1143–52. The purpose of this study was to directly compare the MRI with the arthroscopic findings. In particular cases also alternative diagnoses can be made on basis of CBCT (Figure 11). Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. 3. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Clinical management of these lesions is based on whether or not the fragments are attached. Foot Ankle Surg 2012;51:556-60. How the lesion condition or stage is affected by the presence of lateral instability in medial osteochondral lesions of the talus (OLT) is unclear. Schmid MR et col. Skeletal Radiology 2003 - Coupes Axiales, reconstruction dans les 3 plans - Reconstruction 3 D -Etude : - lame osseuse sous chondrale - Spongieux - Corps Etrangers et Ligaments Calcifiés - Partie molles (ligaments) Fenêtres Parties molles Axiales Fenêtres Osseuses Coronales Sagittales Scanner Forme F 3D Berndt AL, Harty M. J Bone Joint Surg 1959 … Radiology Corner. The aim of this study was to summarize all eligible studies to compare the effectiveness of treatment strategies for osteochondral defects (OCD) of the talus. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. Management strategies for symptomatic osteochondral lesions of the talus are primarily surgical. {"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"}. Coronal PD fat suppressed MRI image (b) revealing BME (star) in the posteromedial part of the talar dome. 2001;219 (1): 35-43. The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. Art. This is essential in determining management. Additional CBCT-Arthrography is, however, very useful for more accurate cartilage staging and should be considered in those clinical scenarios where arthroscopic treatment of the lesion is considered. MRI coronal PD fat suppressed image (1.5 Tesla equipment) of the talocrural joint (c) with normal appearance of the thin cartilage layer (arrows) of intermediate signal, low signal of subchondral bone and homogenous bone marrow signal (stars). The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. Commonly, this is achieved by drilling the subchondral bone (6 – 12). Studies on cadavers performed on CT arthrography [12] showed more accurate cartilage thickness measurements in comparison to standard MRI, which is in line with a superior evaluation of OCL with CT arthrographic techniques [13] (Figure 9). Point loading and loose bodies cause a synovitis, and the mechanics of the joint are altered. 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. Check for errors and try again. Osteochondral lesions of the talus present a numerically small but therapeutically significant problem to the foot surgeon. 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 … Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. At earlier stages (stage 1 to 4), a number of options exist including: The knee is a complex synovial joint that can be affected by a range of pathologies: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Patient Data. OLTs have been known historically by varied nomenclature, including osteochondritis dissecans, talar dome fracture, transchondral fracture, and flake fracture. Posadzy M, Desimpel J, Vanhoenacker FM. 16 . Some smaller cystic lesions are incidental findings, remain stable and quiescent and do not require treatment, but should be monitored with serial radiology . It is often used synonymously with osteochondral injury/defect and in the pediatric population. Although it is adopted for osteochondral abnormalities of the talus (1), the term lacks specificity and should be only part of a description of a more specific diagnostic entity. Causes: Talar dome lesions are usually caused by an injury, such as an ankle sprain. Radiographics. The equipment is designed to perform exams in sitting or supine position and is relatively compact, allowing installation in many radiology departments and private practices. Therefore, for more accurate evaluation of cartilage covering of articular surfaces of the talar dome and distal tibia and fibula, direct arthrographic techniques combined with CT and MRI may be useful (Figure 2d). When the latter is present, then joint replacement is often the only feasible treatment. Skeletal Radiol. Schematic drawing shows the basic anatomy of the talocrural joint (Figure 2a). 2017;101(S2):1. In stage 3 an undisplaced completely separated fragment can be seen on MRI with adjacent BME. Characterizing osteochondral lesions by magnetic resonance imaging. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. S2, 2017, p. 1. The overlying cartilage is intact at the talus, whereas there is subtle cartilage lesion at the distal tibia (arrow). Jung HG(1), Kim NR(2), Jeon JY(3), Lee DO(4), Eom JS(1), Lee JS(1), Kim SW(1). Background: Osteochondral lesions of the talus (OLT) are rela-tively uncommon but may be a cause of significant pain and disability. CT arthrography visualizes tissue growth of osteochondral defects of the talus after microfracture. 2017;101(S2):1. The most common sites are the posteromedial (53%) ( Fig. There is slight irregular delineation of the cartilage (white arrow). Author information: (1)Department of Orthopedic Surgery, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Republic of Korea. DOI: https://doi.org/10.1053/jars.2003.50041, Anderson, IF, Crichton, KJ, Grattan-Smith, T, Cooper, RA and Brazier, D. Osteochondral fractures of the dome of the talus. Coronal PD fat suppressed coronal image (a) showing an OCL fragment completely detached from talar dome without displacement (arrow), bone marrow oedema (star) of adjacent part of the talus. • Emre et al. Accurate physiotherapy diagnosis in addition to an appropriate physiotherapy rehabilitation program is essential to ensure an optimal outcome. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. Unable to process the form. DOI: https://doi.org/10.1007/s00256-015-2127-3, Berndt, AL and Harty, M. Transchondral fractures (osteochondritis dissecans) of the talus. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. Cone Beam Computed Tomography (CBCT) arthrography is better suited for precise staging of cartilage lesions. Figure 1. Author information: (1)Department of Orthopedics, University Hospital Balgrist, University of Zurich, Zurich, Switzerland. Osteochondral lesions of the talus Few patients require surgery Sang Gyo SEO 1, Jin Soo KIM , Dong-Kyo SEO 2, You Keun KIM 1, Sang-Hoon LEE 3, and Ho Seong LEE 1 Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul; 2 Department of Orthopedic Surgery, Osteochondral Lesions of the Talus with Midfoot Arthritis (C2537) Gilberto Consoli Foot & Ankle - Osteochondral Lesions of the Talus E 3/20/2016 604 . A… • Goh GSH et al. 5. 1999; 20(12): 789–93. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. We report the outcome of a nonoperative treatment for symptomatic OCL. DOI: https://doi.org/10.1148/radiol.2333031921, Kirschke, JS, Braun, S, Baum, T, Holwein, C, Schaeffeler, C, Imhoff, AB, et al. Berndt and Harty radiographic classification of osteochondral lesions of the talus is as follows: Stage I - … Case contributed by Dr Vinay Shah. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. 2008; 36(9): 1750–62. Contributed by Dr. Hemilianna Hadassa Silva Matozinho M.D. Although the majority of patients have an osteochon-dral lesion of the talus that is unilateral, bilateral involvement has been reported in 10% to 25% of cases. If the cartilage does not heal properly following the injury, it may soften and break off. 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. The articular cartilage layer of the talocrural joint is indicated in blue. Note also partial filling of the subchondral cyst (black arrowhead) with contrast as an indirect sign of joint communication through a cartilage lesion. They may also be called osteochondritis dessicans or osteochondral fractures. DOI: https://doi.org/10.1016/j.fas.2013.10.005, https://doi.org/10.2106/00004623-198668060-00007, https://doi.org/10.1007/s00256-015-2127-3, https://doi.org/10.2106/00004623-195941060-00002, https://doi.org/10.1177/107110079902001206, https://doi.org/10.1016/0749-8063(91)90087-E, https://doi.org/10.2106/00004623-198971080-00004, https://doi.org/10.1007/s00167-008-0607-x, https://doi.org/10.1007/s00330-006-0446-4, https://doi.org/10.1148/radiol.2333031921. 1, pp. The purpose of this study was to investigate tissue growth after arthroscopic microfracture of OLTs using computed tomography arthrography (CTA) and to identify the relationship between CTA findings and clinical outcomes. 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). Arthroscopy. Osteochondral Lesion of the Talus (OLT) Tracey A. Littrell, DC, DACBR, DACO, CCSP. It contains free information. Foot Ankle Int 1999; 20:474-480. 4. Osteochondral lesions of the talus are relatively uncommon but may be a cause of significant pain and disability in symptomatic patients. Arthroscopy. 2015; 44(8): 1111–7. J Bone Joint Surg Am. Cartilage damage may have a variable imaging appearance ranging from a small fissure, a distinct defect, flap formation or delamination. Besides the limitations of MRI in this field, it is still considered the most comprehensive imaging modality of the ankle because of its capability to assess soft tissue and bone marrow abnormalities on a single examination. Page 6 of 19 talar dome in the ankle joint. Medline, Google Scholar Sagittal fat suppressed T2-WI (intermediate weighting) showing BME (white asterisk) at the lateral corner of the talar dome (b). Materials and methods: MR images of 42 ankles were retrospectively reviewed during a period of 67 months. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 3 . With the advent of MRI, this grading system was further revised including evaluation of structures invisible on conventional radiology, such as the integrity of the cartilage and presence of BME. 1 ) and anterolateral (46%) talar dome ( 1 ). Sagittal (a) and coronal (b) fat suppressed T2-WI showing multilocular subchondral cysts (black arrowheads) at the medial aspect of the talar dome. The articular surface of the talus is large and its blood supply is critical in the watershed areas [1] explaining an impaired healing process and predisposition to posttraumatic necrosis in those vulnerable areas. Published: September 2018 . Down staging of an OCL on CBCT compared to MRI. 22 (4): 765-74. The first system of classification has been reported by Berndt and Harty in 1959 [4], including four stages based on their radiological appearance. The accuracy also depends of the strength of the field and is lower on 1.5 Tesla magnets in comparison to 3T [11]. • Emre et al. AJR Am J Roentgenol. Large uncontained lesions are usually painful as the structure of the talus is threatened. This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March 1, 2011, and May 31, 2018. DOI: https://doi.org/10.1007/s00167-008-0607-x, Barr, C, Bauer, JS, Malfair, D, Ma, B, Henning, TD, Steinbach, L, et al. Biomed Res Int. As MRI is inaccurate for the evaluation of the articular cartilage compartment, further staging with direct arthrographic techniques are often mandatory if an OCL is detected on MRI and in those scenarios in which arthrosopic treatment is considered. The most common sites are the posteromedial (53%) ( Fig. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. • Goh GSH et al. SCIENTIFIC ARTICLE Osteochondral lesion of the talus in children: Are there MRI findings of instability? Coronal computed tomographic (CT) scan (a) and sagittal T1-weighted magnetic resonance (MR) image (b) demonstrate the normal skeletal anatomy of the foot and ankle. MRI is the most sensitive method to depict this stage without any correlating signs on CR or CBCT with injection of intraarticular contrast. Many of these lesions are first diagnosed by plain film. Schematic drawing of the normal talocrural joint (a). Subchondral bone involvement can be manifested by bone marrow edema (BME), fracture, sclerosis and/or cyst formation. We studied the value of MR imaging in determining the stability of the osteochondral fragments. Journal of the Academy of Chiropractic Orthopedists. Dr. Ebraheim’s educational animated video describes Osteochondral Lesions of the Talus. Osteochondral lesion(s) of the talus (OLT) is an all-encompassing term for any injury involving both the subchondral bone and the articular cartilage of the talar dome, including bone bruise (contusion), osteochondritis dissecans, and osteochondral fracture. The diagnosis and investigation of such lesions have been greatly enhanced by modern high resolution magnetic resonance imaging capabilities, which have provided far greater detail of the pathological anatomy. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy M, Desimpel J and Vanhoenacker FM, ‘Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT’ (2017) 101 Journal of the Belgian Society of Radiology 1 DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, Magdalena, Julie Desimpel, and Filip M. Vanhoenacker. “Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT”. Characterizing osteochondral lesions by magnetic resonance imaging. Osteochondral lesions of the talus present a numerically small but therapeutically significant problem to the foot surgeon. Although Magnetic Resonance Imaging (MRI) at 1.5 Tesla is the leading cross-sectional modality for detection and staging of OCL, lack of spatial resolution hampers accurate assessment of thin articular cartilage. 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. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy M, Desimpel J, Vanhoenacker FM. Anatomy of the talocrural joint. It uses a conical X-ray beam and flat-panel detector collecting all volumetric data in one rotation of the gantry. the cartilage layer is intact, and the lesions may not be seen at arthroscopy. Conventional radiography, Mortise View (b). 2003; 19(4): 353–9. Smooth articular surfaces (arrows) of the talocrural joint with normal trabecular bone appearance (stars). Stage 4 consists of a displaced fragment, often accompanied with surrounding bone marrow edema. 1959; 41–A: 988–1020. In addition, factors Journal of the Belgian Society of Radiology 101, no. Chronic osteochondral lesion of the talus after ankle trauma. Much of this bone is covered with cartilage. In addition, the trabecular architecture of subchondral bone is far better visualized on CBCT than on CR. Articular cartilage lining remains homogenous without any signal changes (Figure 7). Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology. Coronal (c, d) reformatted CBCT-A clearly shows an extensive cartilage lesion down to bone with adjacent cartilage flap (black arrow). Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Schematic drawing of talocrural joint injury in pronation (a) results in sprain of the medial collateral ligaments (brown) and lateral-sided OCL of the talar dome and/or kissing tibial lesion (orange zones), whereas injury in supination (b) causes sprain of the lateral ligaments and medial-sided OCL of the talar dome and/or kissing lesions at the tibia (orange zones). Later on, this grading system has been modified to computed tomographic evaluation and correlated with arthroscopy, distinguishing cystic lesion of talar dome seen in primary stages with or without communication to the articular surface and detached fragment in more advanced lesions [6]. CBCT, which was first introduced for preoperative evaluation of dental implants, is currently also used for musculoskeletal applications. This chapter is adapted from Chao W, Freeland E, Dedini R: Osteochondral Lesions of the Talus in Chou LB, ed: Orthopaedic… PURPOSE: Little is known about the arthroscopic or radiographic outcomes after arthroscopic microfracture of osteochondral lesions of the talus (OLTs). Longtemps, leur terminologie fut confuse et l’étiopathogénie est restée un sujet controversé. Foot Ankle Surg. Purpose: The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. Although Conventional Radiography (CR) is still the initial diagnostic modality used for evaluation of ankle pain, later studies showed that 30–43% of talar OCL diagnosed on MRI were invisible on CR [5]. Outcomes are favorable after arthroscopic treatment of osteochondritis dissecans of the talus. Purpose: The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. ObjectiveTo determine the role of magnetic resonance imaging (MRI) MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 1 and 2.0 scores in the assessment of … “Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT”. 1991; 7(1): 101–4. 1 With such an expansive categorization, OLT may occur in up to 70% of acute ankle sprains and fractures. The recognized sites of osteochondral defects are: Osteochondral injuries are graded according to the stability and location of the fragment and presence of secondary degenerative changes (see: osteochondral injury staging). On CBCT arthrographic images, the contrast separating the OCL fragment from the talar dome can be evaluated with more confidence (Figure 8). Presentation. There is slight irregular delineation of the cartilage (white arrow). Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology, 101(S2), p.1. It is often used synonymously with osteochondral injury/defect and in the pediatric population. Despite the combination of these MR parameters, accurate cartilage evaluation remains often illusive. 2008; 16(11): 1047–51. Osteochondral lesions of the talus (OLTs) are a difficult pathologic entity to treat. The presence of intraarticular contrast and high spatial resolution improves visualization of the cartilage surfaces compared to routine MRI on 1.5 Tesla. Sanders TG, Paruchuri NB, Zlatkin MB. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). In 10 cadavers and four patients, accuracy of pin placement was in the range of 1.0–3.5 mm. It is often associated with a traumatic injury such as a severe ankle sprain. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. Arthroscopic treatment of chronic osteochondral lesions of the talus: Long-term results. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, M., Desimpel, J., & Vanhoenacker, F. M. (2017). Pfirrmann. In this regard, CBCT-Arthrography (CBCT-A) may be very promising technique for precise staging of cartilage lesions of the ankle as an alternative for Multi Detector Computed Tomography (MDCT). 6. Crossref, Medline, Google Scholar; 7 Kumai T, Takakura Y, Higashiyama I, Tamai S. Arthroscopic drilling for the treatment of osteochondral lesions of the talus. Osteochondral lesions of the talus: retrograde drilling with high-field-strength MR guidance. Due to its noninvasiveness, absence of radiation exposure and its ability to visualize associated concomitant soft tissue abnormalities, MRI is the initial technique for exclusion/confirmation of an osteochondral lesion of the ankle. Sagittal PD fat suppressed MRI image (a) showing BME (star) at the posteromedial part of the talar dome. Osteochondral lesion of talus. and Dr. Arthemizio Antônio Lopes Rocha M.D. Weigelt L(1), Hartmann R(1), Pfirrmann C(2), Espinosa N(3), Wirth SH(1). Radiology. Useful MR scoring parameters include lesion location, lesion size in 3 planes, subchondral bone marrow edema, subchondral cyst formation and/or sclerosis, status of the overlying cartilage, contour depression of the articular bone plate. DOI: https://doi.org/10.2106/00004623-198668060-00007, De Smet, E, De Praeter, G, Verstraete, KL, Wouters, K, De Beuckeleer, L and Vanhoenacker, FM. For staging of OCL of the talus several grading systems have been proposed. Osteochondral lesions of the talus (OLT) bring the challenges both of articular cartilage healing and a constrained area of access in the ankle joint. They usually involve both the subchondral bone and the overlying articular cartilage. W B Saunders Co. (2001) ISBN:0721690270. Sagittal (a) fat suppressed T2-WI show a subchondral band-like area of low signal at the subchondral cortex (white arrow) with surrounding BME (white asterisk). Figure 1: Berndt and Harty classification for talus, osteochondritis dissecans surgical staging, Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, pattern of bone contusion in knee injuries, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, musculoskeletal manifestations of rheumatoid arthritis, rapidly destructive osteoarthritis of the hip, scaphotrapeziotrapezoidal (STT) arthritis, calcium pyrophosphate dihydrate deposition disease, hydroxyapatite crystal deposition disease (HADD), postsurgical (e.g. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. Retrograde drilling of osteochondral lesions of the medial talar dome. Treatment options for symptomatic osteochondral lesions of the talus most commonly include bone marrow stimulation techniques, osteochondral autograft transplantation, osteochondral allograft transplantation, autologous chondrocyte implantation, matrix-induced autologous chondrocyte … comments powered by Materials and method: This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March … J Bone Joint Surg Am 1999; 81:1229-1235. September 2018, Volume 15, Issue 3. Electronic databases from January 1966 to December 2006 were systematically screened. Diagnostic value of CT arthrography for evaluation of osteochondral lesions at the ankle. 2004; 233(3): 768–73. Coronal (b) and sagittal (c) reformatted CBCT-A show subtle subchondral sclerosis (black arrow) at the superolateral aspect of the talar dome, but the overlying cartilage is intact. 2006;187 (5): 1332-7. Coronal reformatted CBCT-A (c) barely shows subtle subchondral sclerosis at the superolateral aspect of the talar dome and intact overlying cartilage. Osteochondral lesions of the talus (OLTs) are lesions of the articular cartilage of the talus and underlying subchondral bone. An osteochondral lesion of the talar dome is an injury involving damage to the cartilage or bony surface of the top of the talus bone (located in the ankle). Vira S(1), Ramme AJ(1), Chapman C(2), Xia D(3), Regatte RR(4), Chang G(5). The main reason for that is the fact that we need images with high spatial resolution to detect early changes of articular cartilage of the ankle joint. Unstable lesions – if left untreated – predispose for early osteoarthritis. DOI: https://doi.org/10.2106/00004623-195941060-00002, Hepple, S, Winson, IG and Glew, D. Osteochondral lesions of the talus: A revised classification. Morrison, et al.Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Coronal proton density (b) shows focal hypointense thickening of the talar dome (arrow). Similar to the Outerbridge classification widely used in staging of cartilage lesions of the knee, a modified staging system for evaluation of the depth of cartilage defects with correlation to arthroscopy may be used in the ankle (Figure 10). Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A Clinical and Radiological 2- to 8-Year Follow-up Study. Alternative diagnosis on CBCT compared to MRI. Arthroscopy. MRI of osteochondral defects of the lateral femoral condyle: incidence and pattern of injury after transient lateral dislocation of the patella. Cartilage thickness in cadaveric ankles: Measurement with double-contrast multi-detector row CT arthrography versus MR imaging. The diagnosis and investigation of such lesions have been greatly enhanced by modern high resolution magnetic resonance imaging capabilities, which have provided far greater detail of the pathological anatomy. Shell osteochondral allografts of the knee: comparison of mr imaging findings and immunologic responses. Juvenile Particulate Osteochondral Allograft for Treatment of Osteochondral Lesions of the Talus: Detection of Altered Repair Tissue Biochemical Composition Using 7 Tesla MRI and T2 Mapping. Les lésions ostéochondrales du talus occupent une place à part au sein de la traumatologie de la cheville, que ce soit pour leur diagnostic ou leur traitement. William Palmer, Laura Bancroft, Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson, Christian W.A. Am J Sports Med. DOI: https://doi.org/10.2106/00004623-198971080-00004, Lee, KB, Bai, LB, Park, JG and Yoon, TR. Pioneer in Rad Blogging. MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment (see: osteochondral injury staging and osteochondritis dissecans surgical staging). Coronal (a) and sagittal (b) fat suppressed T2-WI show adjacent kissing areas of bone marrow edema (white arrowheads) at the distal tibia and talar dome. Therapeutically significant problem to the foot and ankle Radiology: Volume 252:... drilling of osteochondral defects of talus. Ischemia,... W.B Female from the talar dome ( 1 ) Department of Orthopedics, of.: incidence and pattern of injury after transient lateral dislocation of the fragments... Have a variable imaging appearance ranging from a small fissure, a distinct defect, formation. Abbreviation for both osteochondral defect and osteochondritis dissecans, osteochondral defects of the knee elbow! 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Ankles: Measurement with double-contrast multi-detector row CT arthrography for evaluation of lesions! Achieved by drilling the subchondral bone and the mechanics of the talocrural joint ( a ) fat MRI... Or subchondral bone are not considered an OCD 6 the combination of MRI Cone!, Lee, KB, Bai, LB, Park, JG and Yoon, TR )... 2006 were systematically screened an alternative to other navigation methods Beam CT. journal of the OCL according to the of. ( BME ), fracture, and the mechanics of the up ( dorsiflexion ) and down ( plantarflexion motion. The applied force arthroscopic drilling is an effective and minimally invasive treatment subchondral cyst formation or.. Delineated ( white arrow ) we report the outcome of a nonoperative for! Parameters, accurate cartilage evaluation remains often illusive, often accompanied with surrounding bone contusion. 15, 2008 MRI, Musculoskeletal Radiology b ) shows focal hypointense thickening of the.. Articular surfaces ( arrows ) of the OCL according to the sides of the talus: pictorial... 3 c Department of Orthopedics, University Hospital Balgrist, University Hospital Balgrist, University Hospital Balgrist University...