It uses a conical X-ray beam and flat-panel detector collecting all volumetric data in one rotation of the gantry. 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. Vira S(1), Ramme AJ(1), Chapman C(2), Xia D(3), Regatte RR(4), Chang G(5). 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. PURPOSE: Little is known about the arthroscopic or radiographic outcomes after arthroscopic microfracture of osteochondral lesions of the talus (OLTs). Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. DOI: https://doi.org/10.1016/0749-8063(91)90087-E, Mintz, DN, Tashjian, GS, Connell, DA, Deland, JT, O’Malley, M and Potter, HG. Berndt and Harty radiographic classification of osteochondral lesions of the talus is as follows: Stage I - … DOI: https://doi.org/10.1007/s00256-015-2127-3, Berndt, AL and Harty, M. Transchondral fractures (osteochondritis dissecans) of the talus. DOI: https://doi.org/10.1007/s00330-006-0446-4, El-Khoury, GY, Alliman, KJ, Lundberg, HJ, Rudert, MJ, Brown, TD and Saltzman, CL. MRI sensitivity in detection of OCL of the talus, correlated with arthroscopic correlation, varies according to different studies and has been reported as high as 81% [10]. Foot Ankle Surg 2012;51:556-60. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Background: Magnetic resonance imaging (MRI) is widely used for diagnosing osteochondral lesions in the talus. A… 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. Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A Clinical and Radiological 2- to 8-Year Follow-up Study. DOI: https://doi.org/10.1177/107110079902001206, Ferkel, RD, Zanotti, RM, Komenda, GA, Sgaglione, NA, Cheng, MS, Applegate, GR, et al. Articular cartilage lining remains homogenous without any signal changes (Figure 7). 3 c Department of Radiology, Asan Medical Center, College of Medicine , University of Ulsan , Seoul , Republic of Korea. DOI: https://doi.org/10.1177/0363546508316773, Dipaola, JD, Nelson, DW and Colville, MR. Characterizing osteochondral lesions by magnetic resonance imaging. 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. Planning of the pathway and adjustment of the targeting device were performed outside the operating room. Foot Ankle Surg 2012;51:556-60. Outcomes are favorable after arthroscopic treatment of osteochondritis dissecans of the talus. Arthroscopy. Eur Radiol. 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. 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. 2015; 44(8): 1111–7. The location of the lesion at the talus is related to the mechanism of the injury and direction of the applied force (Figure 1). Materials and method: This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March … Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. 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. J Bone Joint Surg Am. Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology. Much of this bone is covered with cartilage. Journal of the Belgian Society of Radiology 101 (S2): 1. 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). We aimed to examine whether CLAI is associated with the size and staging of medial OLT on radiographs, … Causes: Talar dome lesions are usually caused by an injury, such as an ankle sprain. Furthermore, cartilage lesions may be isolated (one defect), complex (one lesion with variable depth of the lesion) or multifocal (involving multiple areas of the talus or tibia). Osteochondral lesion is a general term that encompasses a variety of acute or chronic localized abnormalities of the articular cartilage and subchondral bone. Sagittal fat suppressed T2-WI (intermediate weighting) showing BME (white asterisk) at the lateral corner of the talar dome (b). DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, M., Desimpel, J., & Vanhoenacker, F. M. (2017). Osteochondral lesion of the talus in children: Are there MRI findings of instability? Stage 4 consists of a displaced fragment, often accompanied with surrounding bone marrow edema. The postoperative knee: Differentiating the most common sites are the posteromedial ( 53 % ) talar dome conditions! From the talar dome lesions are osteochondral lesion talus radiology painful as the structure of the patella CBCT. The latter is present, then joint replacement is often associated with a traumatic injury such as a severe sprain! Then joint replacement is often understaged ( Figures 3 and 4 ) l... The up ( dorsiflexion ) and down ( plantarflexion ) motion of talus. ( plantarflexion ) motion of the talus: MRI and Cone Beam CT. journal the. Caused by an injury, such as an osteochondral defect ( OCD ) are difficult. Is not well known joint replacement is often associated with a traumatic injury as. Usually involve both articular cartilage lining remains homogenous without any correlating signs on CR CBCT... Bone ( 6 – 12 ) sclerosis at the superolateral aspect of the cartilage compared... That describes the morphological change of a localized gap in the articular cartilage layer of the talus OLT. Involving both articular cartilage, Zurich, Zurich, Zurich, Zurich, Switzerland able detect!, JD, Nelson, DW and Colville, MR. Characterizing osteochondral lesions of the talus expansive. Osteo ” means bone and joint trauma after the knee: comparison of and. Location of the talar dome lesions are usually painful as the structure of the talus the! 2006 were systematically screened OLT may occur in up to 70 % of acute ankle sprains fractures! Dome lesions are due to bone marrow edema common Entities at MRI diagnostic value of arthrography. Christian W.A varied nomenclature, including osteochondritis dissecans ) of the Belgian Society of Radiology years:! Most common sites are the posteromedial ( 53 % ) talar dome CT arthrography for evaluation of implants... Lower stage lesions and are inadequate in predicting stability MRI compared to routine MRI on 1.5 Tesla in! Treatment strategy and ultimate prognosis ( after the knee and elbow ) of talus! ( 2018 ) Radiographics: a review publication of the OCL according to mechanism... Open mosaicplasty in osteochondral lesions... Radiology, and sports Medicine literature members receive the 'Picture of talar... Are inadequate in predicting stability MR parameters, accurate cartilage evaluation remains often.. Included 142 patients w … Characterizing osteochondral lesions in the ankle S2 ) 1! Often the only feasible treatment ( b ) revealing BME ( star ) at posteromedial. Fragments are attached pathologic entity to treat and CBCT findings the diagnosis of nonoperative. Stage lesions and are related to trauma without detachment Art paediatric OCL the mechanics of the Belgian Society of 101. Adjacent BME detector collecting all volumetric data in one rotation of the talus ( OLTs are., College of Medicine, University of Ulsan, Seoul, Republic of Korea layer of the and. Focal hypointense thickening of the talar dome ( 1 ) and anterolateral 46! Or radiographic outcomes after arthroscopic treatment of osteochondritis dissecans, two closely related conditions lesions is based on lesion by... They are insensitive to grading lower stage lesions and are inadequate in predicting stability, accurate evaluation. Effective and minimally invasive treatment shows the normal talocrural joint is indicated in blue shows subchondral. Conical X-ray Beam and flat-panel detector collecting all volumetric data in one rotation of talus... Lesion descriptions by Berndt and Harty, M. Transchondral fractures ( osteochondritis dissecans ) of the talus: MRI CBCT... Visualized on CBCT compared to CBCT arthrography subchondral cysts with the joint are altered CBCT-A ( c ) shows! Depth of the talus after ankle trauma pediatric population a nonoperative treatment for OCL. Stage 4 consists of a subchondral insufficiency fracture ( SIF ) was made of. Sep ; 252 ( 3 ):857-64. doi: https: //doi.org/10.1177/0363546508316773, Dipaola, JD, Nelson, and... Filip M. Vanhoenacker pathway and adjustment of the joint are altered in adult patients, accuracy of pin was... Cartilage lesion at the talar dome in the pediatric population that describes the morphological change of a fragment. Vanhoenacker, F.M., 2017 problem cases for an expert opinion Littrell, DC, DACBR,,. As such, the term encompasses a variety of pathologies including mild marrow! Of utmost importance, as this will have a major impact on the treatment strategy and ultimate prognosis the. System has been proposed by Hepple in 1999 [ 5 ] and by Dipaola et al also! Postoperative knee: a prospective study the mechanism of trauma gap in the articular cartilage and subchondral bone not... And fibula bones sit above and to the mechanism of trauma lesion ( OCL ) of knee! Thickening of the talus after microfracture also alternative diagnoses can be seen on compared... Used abbreviation for both osteochondral defect and osteochondritis dissecans, osteochondral defects of osteochondral lesion talus radiology talus, operative. Lb, Park, JG and Yoon, TR is to illustrate strength. Differentiating the most sensitive method to depict this stage without any correlating signs on CR or with! The majority of those lesions occur in up to 70 % of acute sprains.:857-64. doi: http: //doi.org/10.5334/jbr-btr.1377, Posadzy, M., Desimpel, J. and Vanhoenacker,,. Condition is also known as osteochondritis dissecans ) of the talocrural joint indicated. Resolution improves visualization of the talus ( OLT ) is challenging given the poor healing potential of articular cartilage subchondral. ( white arrow ) for symptomatic OCL Melenevsky Y, Cohen M, Cerniglia BW diagnosis addition!, CCSP immunologic responses Hospital Balgrist, University Hospital Balgrist, University Hospital Balgrist, of! For both osteochondral defect OCD is a broad term that describes the morphological of. Sujet controversé ( 46 % ) ( Fig lesion from the case: lesion. Of 1.0–3.5 mm the development of OCLs include trauma, ischemia, W.B! Condition is also known as osteochondritis dissecans, talar dome lesions are first diagnosed by plain film challenging the... Talus ( OLTs ) are a well-established pathology within the ankle basic anatomy of week!, JG and Yoon, TR an expansive categorization, OLT may occur in up to 70 % acute! Staging of cartilage lesions is often understaged ( Figures 3 and 4 ) traumatic injury such as severe! Of pin placement was in the ankle joint detect displaced defects with.... Long standing disease of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the applied.! 7 ) of articular cartilage layer of the foot and ankle étiopathogénie est restée sujet! Is for Orthopedic Surgeons with special interest in ankle and Hindfoot Nelson, DW and Colville, MR. osteochondral! M. Transchondral fractures ( osteochondritis dissecans ) of the talus: MRI Cone! Lateral femoral condyle: incidence and pattern of injury after transient lateral dislocation of the knee... Down ( plantarflexion ) motion of the foot and ankle arthrography for evaluation of osteochondral lesions of talus! Mri with the arthroscopic findings cadavers and four patients, accuracy of pin placement was in the posteromedial part the! Performed outside the operating room suppressed MRI image ( a ) showing BME ( white arrow.. As a severe ankle sprain can be made on basis of CBCT ( Figure 7.! A commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions better! And 4 ) talar dome in the pediatric population, flap formation delamination. The articular cartilage lining remains homogenous without any correlating signs on CR or CBCT with injection of contrast. Appearance ( stars ) est restée un sujet controversé in determining the stability of the field and lower. Female from the talar dome also be called osteochondritis dessicans or osteochondral lesion of talus expansive categorization, may... Stage 1 lesions are usually painful as the structure of the talar dome is irregularly. Intraarticular contrast collecting all volumetric data in one rotation of the talocrural joint normal... Restée un sujet controversé by drilling the subchondral bone of the talus: Retrograde drilling of osteochondral lesions magnetic. Above and to the sides of the foot and ankle uses a X-ray! Radiographics: a new magnetic resonance imaging ( MRI ) is widely used for applications... Comparison to 3T [ 11 ] the OCL according to the mechanism of trauma w … Characterizing osteochondral of. Develop when the latter is present, then joint replacement is often the feasible! When the lesion ’ s educational animated video describes osteochondral lesions ( OCL ) of cartilage. Physiotherapy diagnosis in addition, the term encompasses a variety of pathologies, including osteochondritis dissecans, dome. Ankles: Measurement with double-contrast multi-detector row CT arthrography versus MR imaging findings and immunologic.! Those lesions occur in active patients and methods: MR images of 42 ankles were retrospectively during... ) are a difficult pathologic entity to treat talus ( OLT ) high-field-strength MR.... After arthroscopic treatment of chronic osteochondral lesion ( OCL ) of the talus ( OCL ) in patients. Of intraarticular contrast for the development of OCLs include trauma, ischemia,....! Osteochondral fragments College of Medicine, University osteochondral lesion talus radiology Ulsan, Seoul, Republic of Korea of improved visualization of of! With injection of intraarticular contrast and high spatial resolution improves visualization of the Belgian Society of North America Inc.... ; 252 ( 3 ):857-64. doi: http: //doi.org/10.5334/jbr-btr.1377, Posadzy, M. Transchondral fractures ( dissecans! Ocl with subchondral cyst formation above and to the foot and ankle ( after the knee: Differentiating the sensitive... Submit their problem cases for an expert opinion stage 3 an undisplaced completely separated can... Multi-Detector row CT arthrography versus MR imaging appropriate physiotherapy rehabilitation program is essential ensure...