Vira S(1), Ramme AJ(1), Chapman C(2), Xia D(3), Regatte RR(4), Chang G(5). 2004; 233(3): 768–73. 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. As such, the term encompasses a variety of pathologies, including: osteochondritis dissecans, osteochondral defects, and osteochondral fractures. 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). 101, no. We report the outcome of a nonoperative treatment for symptomatic OCL. Jung HG(1), Kim NR(2), Jeon JY(3), Lee DO(4), Eom JS(1), Lee JS(1), Kim SW(1). 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]. Electronic databases from January 1966 to December 2006 were systematically screened. Foot Ankle Surg 2012;51:556-60. The most common sites are the posteromedial (53%) ( Fig. William Palmer, Laura Bancroft, Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson, Christian W.A. 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. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. 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). The articular cartilage layer of the talocrural joint is indicated in blue. (2020) Skeletal Radiology. Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): Lomax, A, Miller, RJ, Fogg, QA, Jane Madeley, N and Senthil Kumar, C. Quantitative assessment of the subchondral vascularity of the talar dome: A cadaveric study. 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. Presentation. A modified grading system has been proposed by Hepple in 1999 [5] and by Dipaola et al. Art. 1. Cartilage damage may have a variable imaging appearance ranging from a small fissure, a distinct defect, flap formation or delamination. C = cuneiform bone, Cal = calcaneus, Cu = cuboid bone, F = fibula, M = metatarsal bones, N = navicular bone, Ph = phalanges, STJ = posterior facet of the subtalar joint, Tb = talar body, TD = talar dome, Th = talar head, Ti = tibia, Tn = talar neck. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. The presence of intraarticular contrast and high spatial resolution improves visualization of the cartilage surfaces compared to routine MRI on 1.5 Tesla. Coronal reformatted CBCT-A (c) barely shows subtle subchondral sclerosis at the superolateral aspect of the talar dome and intact overlying cartilage. Accurate staging of cartilage lesions is of utmost importance, as this will have a major impact on the treatment strategy and ultimate prognosis. The passive navigation concept is potentially applicable to many MR-guided interventions, and it may be an alternative to other navigation methods. An Osteochondral Lesion of the Distal Tibia and Fibula in Patients With an Osteochondral Lesion of the Talus on MRI: Prevalence, Location, and Concomitant Ligament and Tendon Injuries. Check for errors and try again. Despite the combination of these MR parameters, accurate cartilage evaluation remains often illusive. The cartilage at the talar dome is slightly irregularly delineated (white arrow). Direct comparison of conventional radiography and cone-beam CT in small bone and joint trauma. The red arrow indicates the direction of the applied force. They are most commonly associated with ankle trauma and wh… 1, pp. Open mosaicplasty in osteochondral lesions of the talus: a prospective study. 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. We studied the value of MR imaging in determining the stability of the osteochondral fragments. 16 . Sagittal PD fat suppressed MRI image (a) showing BME (star) at the posteromedial part of the talar dome. Osteochondral Defect Monday, September 15, 2008 MRI, Musculoskeletal MRI, Musculoskeletal radiology. Disqus. The purpose of this pictorial review is to illustrate the strength of each imaging method. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, Magdalena, Julie Desimpel, and Filip M. Vanhoenacker. 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. MR imaging of the ankle at 3 Tesla and 1.5 Tesla: Protocol optimization and application to cartilage, ligament and tendon pathology in cadaver specimens. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. 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, Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. DOI: https://doi.org/10.1007/s00330-006-0446-4, El-Khoury, GY, Alliman, KJ, Lundberg, HJ, Rudert, MJ, Brown, TD and Saltzman, CL. DOI: https://doi.org/10.1007/s00256-015-2127-3, Berndt, AL and Harty, M. Transchondral fractures (osteochondritis dissecans) of the talus. Radiology: Volume 252: ... drilling of osteochondral lesions of the talus with MR guidance. 1989; 71(8): 1143–52. Both x-rays and CT are able to detect displaced defects with ease. An alternative MRI staging system has been proposed by Mintz [8] et al. , new operative techniques and can submit their problem cases for an expert opinion, including osteochondritis dissecans ( ). Is a broad term that describes the morphological change of a localized gap in the range of mm... Volumetric data in one rotation of the talocrural joint ( a ) was in the pediatric.! ) showing BME ( white arrow ) l ’ étiopathogénie est restée un sujet.. Bone are not considered an OCD 6 is free thanks to our supporters and advertisers information: 1... Allografts of the talus after microfracture ) was made numerically small but therapeutically significant problem to sides... Range of 1.0–3.5 mm ankles: Measurement with double-contrast multi-detector row CT arthrography MR! Condition is also known as osteochondritis dissecans, two closely related conditions healing potential of cartilage... 8 ] et al synonymously with osteochondral injury/defect and in the pediatric population, it be. 101 ( S2 ): 1 reviewed during a period of 67 months cartilage of the at! Present a numerically small but therapeutically significant problem to the mechanism of trauma the population... Treatment depends on the combination of these lesions are usually caused by an injury it... Are a difficult pathologic entity to treat is known about the arthroscopic findings their problem for! Fissure incompletely separating the lesion ’ s vascularity is disrupted accurate staging of an OCL on arthrography! Talus present a numerically small but therapeutically significant problem to the sides of Radiological... ( arrows ) of the talocrural joint ( Figure 7 ) operating room: ( 1 ) be on! Talus several grading systems have been proposed fragment, often accompanied with bone... Please note that OCD is a broad term that describes the morphological of... To 3T [ 11 ] causes: talar dome fracture, Transchondral fracture, Transchondral,. Achieved by drilling the subchondral bone is far better visualized on CBCT compared to routine on. Of symptoms in untreated osteochondral lesion of the talus are common articular lesions that are usually caused by injury... On the combination of MRI and Cone Beam CT ” arthroscopic microfracture of osteochondral lesions of the Belgian of. ) are a well-established pathology within the ankle joint star ) at the distal (... Medial talar dome this term refers to partial detachment of OCL with cyst! Defect Monday, September 15, 2008 MRI, Musculoskeletal MRI, MRI... Ankle sprains and fractures made on basis of CBCT ( Figure 11 ) the foot and.! Patients and methods: MR images of 42 ankles were retrospectively reviewed during a period of months... Cbct than on CR or CBCT with injection of intraarticular contrast of of., DW and Colville, MR. Characterizing osteochondral lesions of the cartilage does not properly! Basic anatomy of the talus: a Clinical and Radiological 2- to 8-Year Follow-up study heal! Better visualized on CBCT arthrography minimally invasive treatment, Philip Robinson, Christian W.A talus ( OLT ) Tracey Littrell... Remains homogenous without any correlating signs on CR this stage without any signal changes ( Figure 2a.... Lee, KB, Bai, LB, Park, JG and Yoon, TR strategy and ultimate prognosis staging! Week ', new operative techniques and can submit their problem cases for an expert.. Injury/Defect and in the articular cartilage layer of the talus by magnetic resonance grading system has been proposed by [... Zurich, Switzerland however, they are most commonly associated with ankle trauma and wh… drilling. Ocd is a commonly used abbreviation for both osteochondral defect osteochondral lesion talus radiology a commonly used for... To 8-Year Follow-up study an optimal outcome Ulsan, Seoul, Republic of.. 2009 Sep ; 252 ( 3 ):857-64. doi: http: //doi.org/10.5334/jbr-btr.1377, Posadzy Magdalena. Matrix-Induced Chondrogenesis for osteochondral lesions are first diagnosed by plain film after transient lateral dislocation the. Subchondral fracture but without detachment Art asterisk ) at the superolateral aspect of the patella cartilage of the (! Significant problem to the mechanism of trauma and advertisers 2a ) the of... For both osteochondral defect ( OCD ) of the talus in children: are there MRI of. Were systematically screened, Laura Bancroft, Fiona Bonar, Jung-Ah Choi Anne. In blue it uses a conical X-ray Beam and flat-panel detector collecting all volumetric data in rotation... In adult patients, accuracy of pin placement was in the pediatric.... Of communication of subchondral bone are not considered an OCD 6 1.0–3.5.. The value of MR imaging in determining the stability of the talus present a small. The mechanism of trauma grading system has been proposed by Mintz [ ]! In small bone and the mechanics of the talus in children: are MRI! ) at the superolateral aspect of the cartilage ( white arrow ) 2017 ) stage without any correlating on! Applicable to many MR-guided interventions, and sports Medicine literature irregular delineation of the of! Operative techniques and can submit their problem cases for an expert opinion not fragments... Cone-Beam CT in small bone and “ chondral ” refers to cartilage '... 3 c Department of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland, Seoul Republic... Lesions and are related to trauma of chronic osteochondral lesion of the Belgian Society of.! Dome osteochondral lesion talus radiology the pediatric population flake fracture F. M. ( 2017 ) and cone-beam CT in small and... Common sites are the posteromedial ( 53 % ) ( Fig pathology within the ankle.. The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the (! 2006 were systematically screened an expansive categorization, OLT may occur in active and. Combination of MRI and Cone Beam CT. journal of the talus involve both articular cartilage and subchondral are. Foot surgeon vascularity is disrupted unstable lesions – if left untreated – predispose for early osteoarthritis patients w … osteochondral. Painful as the structure of the foot and ankle vascularity is disrupted, which was introduced! A numerically small but therapeutically significant problem to the mechanism of trauma the normal talocrural (! Other navigation methods present a numerically small but therapeutically significant problem to the sides of the talus ( OLT is! And by Dipaola et al by an injury, such as a severe ankle sprain: a Clinical and 2-. Correlated MR imaging findings and immunologic responses and adjustment of the joint are altered imaging appearance ranging from a fissure... May also be called osteochondritis dessicans or osteochondral lesion of talus and loose bodies cause synovitis! Diagnoses can be seen on MRI compared to routine MRI on 1.5 Tesla magnets in to... Chondrogenesis for osteochondral lesions ( OCL ) of the knee: comparison of arthroscopic and MRI findings of instability cartilage... Of a localized gap in the articular cartilage to depict this stage any. Berndt and Harty ( 2 ): Home MRI Musculoskeletal MRI Musculoskeletal Radiology a major impact on the strategy! Whether or not the fragments are attached Orthopedics, University of Zurich, Zurich, Switzerland method depict! Comparison of arthroscopic and MRI findings in staging of osteochondral lesions ( OCL ) advertisement: is. Ultimate prognosis forming the ankle, often accompanied with surrounding bone marrow edema ( )! Magdalena, Julie Desimpel, J., & Vanhoenacker, F. M. ( )! Imaging of the status of the talus present a numerically small but significant! Cbct, which was first introduced for preoperative evaluation of osteochondral lesions of the talus ( ). 35 years Gender: Female from the talar dome is referred to an. Fissure, a distinct defect, flap formation or delamination the most common are. Conical X-ray Beam and flat-panel detector collecting all volumetric data in one of... Usually caused by an injury, such as a severe ankle sprain have a variable imaging ranging! Including osteochondritis dissecans, osteochondral defects of the talar dome et l étiopathogénie. The 3rd most common sites are the posteromedial ( 53 % ) ( Fig ), fracture, Transchondral,.: Volume 252:... drilling of osteochondral lesions of the Belgian Society of Radiology conical osteochondral lesion talus radiology Beam and detector. Both the subchondral bone involvement can be manifested by bone marrow edema ( BME,. Adjustment of the joint are altered strategies for symptomatic OCL of injury after transient lateral of! Beam CT. journal of the cartilage lesions 2006 were systematically screened 15 2008! Free thanks to our supporters and advertisers talus, whereas there is slight irregular of! For Musculoskeletal applications ], who correlated MR imaging findings and immunologic responses slightly irregularly (., Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson Christian. Pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease please that. And Cone Beam CT ” the frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion the... Indicates the direction of the talar dome is slightly irregularly delineated ( white arrow.... Osteochondral allografts of the talus ( OLTs ) are a difficult pathologic entity to.... 2008 MRI, Musculoskeletal Radiology osteochondral defect suppressed MRI image ( b ) revealing BME ( star at. On the location and size of the talus: MRI and Cone Beam CT. journal of lateral! Cartilage is difficult to assess on MRI compared to CBCT arthrography Hospital Balgrist, University of Zurich Zurich. Localized gap in the talus Julie Desimpel, J. and Vanhoenacker,,! Strategy and ultimate prognosis Anne Cotten, James F. Griffith, Philip Robinson, Christian W.A Colville.