Learning objectives
1. To review the different staging and classification systems for staging of osteochondral lesions (OCL) of the ankle.
2. To compare our preliminary results of direct comparison of Cone Beam CT (CBCT) arthrography with routine MRI of the ankle in a cohort of 25 patients.
Background
Definition
Osteochondral lesions (OCL) of the talus are defined as any damage involving both hyaline cartilage and subchondral bone of the talar dome.
This term covers a wide spectrum of pathologies including (sub)chondral contusion,
osteochondritis dissecans,
osteochondral fracture and osteoarthritis resulting from longstanding disease.
Subchondral bone involvement can be manifested by bone marrow edema,
fracture,
sclerosis and/or cyst formation.
Cartilage damage may have a variable imaging appearance ranging from a small fissure,
a distinct defect,
flap formation or delamination.
The majority of those lesions occur...
Imaging findings OR Procedure Details
Materials and methods
The original part of this poster exhibit is a direct comparison of MRI and CBCT arthrography of a cohort of 25 patients which a talar OCL.
All patients were referred for MRI imaging due to ankle pain.
Inclusion criteria for subsequent CBCT-arthrography imaging included absence of previous surgery and the presence of a talar dome lesion on MRI. Informed consent was given by all patients after extensive explanation of the imaging procedure of the CBCT-arthrographic examination.
CBCT-arthrographic examination was performed within 1...
Conclusion
1.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.
2.Additional Cone Beam CT 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.
References
Lomax A,
Miller RJ,
Fogg QA,
Jane Madeley N,
Senthil Kumar C (2014) Quantitative assessment of the subchondral vascularity of the talar dome: a cadaveric study.
Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons,
20(1):57-60.
doi: 10.1016/j.fas.2013.10.005
Pritsch M,
Horoshovski H,
Farine I (1986) Arthroscopic treatment of osteochondral lesions of the talus.
The Journal of bone and joint surgery.
American volume,
68(6):862-865.
Berndt AL,
Harty M (1959) Transchondral fractures (osteochondritis dissecans) of the talus.
The Journal of...
Personal Information
Acknowledgement
The authors thank Danny Verreth for his artwork of this exhibit.