Osteochondral defect of the talus
Introduction
Case Introduction
You are evaluating a 17 year old soccer player with persistent ankle pain that has not improved with conservative therapy. She has previously had several ankle sprains. You are suspicious of an osteochondral lesion. Which of the following imaging modalities is most sensitive for osteochondral defects of the talus?
A) Ultrasound
B) CT
C) Radiographs
D) MRI

Image 1. Radiograph of an OCD of the talus[2]van Bergen, Christiaan JA, Mikel L. Reilingh, and C. Niek van Dijk. “Tertiary osteochondral defect of the talus treated by a novel contoured metal implant.” Knee Surgery, Sports … Continue reading
Pathophysiology

Image 2. Osteochondral defect of the talus on CT[5]D’Hooghe, Pieter, et al. “Concomitant injuries in chronic ankle instability.” Clinical Research on Foot and Ankle 6.3 (2018): 7.
Clinical Features

Image 3. OCD lesion of the talus on MRI[6]Youn, Gun Min, et al. “Arthroscopic-assisted osteochondral allograft transplantation for posterolateral lesions of the talus without fibular osteotomy.” Arthroscopy techniques 8.3 (2019): … Continue reading
Evaluation
Management
Case Conclusion
Answer is D, MRI. Imaging modalities are well studied for osteochondral lesions. Radiographs are not sensitive at all. CT is around 80% sensitive and MRI is about 96% sensitive making it the imaging modality of choice. Note that arthroscopy, the gold standard, is 100% sensitive but not routinely used unless an MRI has been previously obtained.
– Read More @ Wiki Sports Medicine: https://wikism.org/Osteochondral_Defect_Talus
References[+]
↑1 | Konig, F: Ueber freie Korper in den Gelenken. Deutsch Z Chir, 27:90 – 109, 1888 |
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↑2 | van Bergen, Christiaan JA, Mikel L. Reilingh, and C. Niek van Dijk. “Tertiary osteochondral defect of the talus treated by a novel contoured metal implant.” Knee Surgery, Sports Traumatology, Arthroscopy 19.6 (2011): 999-1003. |
↑3 | Saxena A, Eakin C. Articular talar injuries in athletes: results of microfracture and autogenous bone graft. Am J Sports Med. 2007;35(10):1680-1687. |
↑4 | Verhagen, Ronald AW, et al. “Systematic review of treatment strategies for osteochondral defects of the talar dome.” Foot and ankle clinics 8.2 (2003): 233-242. |
↑5 | D’Hooghe, Pieter, et al. “Concomitant injuries in chronic ankle instability.” Clinical Research on Foot and Ankle 6.3 (2018): 7. |
↑6 | Youn, Gun Min, et al. “Arthroscopic-assisted osteochondral allograft transplantation for posterolateral lesions of the talus without fibular osteotomy.” Arthroscopy techniques 8.3 (2019): e311-e316. |
↑7 | Verhagen RA, Maas M, Dijkgraaf MG, Tol JL, Krips R, van Dijk CN. Prospective study on diagnostic strategies in osteochondral lesions of the talus: is MRI superior to helical CT? J Bone Joint Surg Br. 2005;87(1):41-46. |
↑8 | Canale ST, Belding RH. Osteochondral lesions of the talus. J Bone Joint Surg Am. 1980;62(1):97-102. |
↑9 | Steman, Jason AH, et al. “Return to sports after surgical treatment of osteochondral defects of the talus: a systematic review of 2347 cases.” Orthopaedic journal of sports medicine 7.10 (2019): 2325967119876238. |