Publicationdate 2019-03-01. Daniel Baumfeld Arthroscopic AMIC for Talus Osteochondral Lesion . The most commonly used system for classifying OCD lesions was presented by Berndt and Harty in 1959, with additional staging described by Scranton and McDermott in 2001. The average age at surgery was 22.7 years (range, 19–34). OCDs of the talar dome are relatively common injuries of the articular surface of the talus. There is likely some overlap in the two forms of the disease, although the general distinction remains the presence (or absence) of an open physis. See the main osteochondritis dissecans article for a general discussion on the pathology of this condition. Synovitis of the tibiotalar and subtalar joint. We asked for an MRI and a OD lesion of the talus was diagnosed and treated by arthroscopy. NYU Langone Orthopedics Lateral Talar Dome Osteochondral … Link, Google Scholar; 44 Whittaker JP, Smith G, Makwana N, et al. Just xrays were performed. William Palmer, Laura Bancroft, Fiona Bonar et-al. subchondral halo outlining the osteochondral fragment, a focal concavity of the articular surface, an intra-articular bone fragment may be seen. 8. Surgery is often needed to better assess the lesion and determine the goal of either lesion healing or removal. S. Labib 07:31. International Congress on Cartilage Repair of the Ankle . 21 (2): 119-26. Question(s) to this case: 1. Ankle Injuries in the Adolescent Athlete: What not to Miss 10:39. (2003) ISBN:0781738954. 56 views January 8, 2020 1 ; 13:01. Treatment Strategy and Surgical Approach for OCD of the Talus Feat. Eighteen symptomatic advanced-stage osteochondritis dissecans (OCD) of the talus (Berndt and Harty stages III 7 and IV 11) in 17 patients were treated with multiple autogenous osteochondral cylindrical grafts. Stage 2 is a partially detached osteochondral fragment. It has no muscular attachments and around 60% of its surface is covered by articular cartilage. The etiology is felt to be related to indirect trauma in most cases but familial factors, avascular necrosis, enchondral ossification abnormalities and fat emboli have been implicated as possible causes as well. MRI is the modality of choice, with high sensitivity (92%) and specificity (90%) 4 in the detection of separation of the osteochondral fragment. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. The average age at initial presentation was 13 years 4 months (range 6 years 7 months to 17 years 1 month). Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. Bone and joint imaging. Joints. Eric Fornari. Such lesions have poor prognoses with nonoperative treatment and typically are addressed with arthroscopic surgery. 1994;29 (4): 302-306. In up to 40% of cases, patients give a history of trauma as the inciting event 3. 2015;2 (3): 115-23. M. Easley 11:10. If an osteochondral fragment becomes unstable and displaced, then donor site and intra-articular fragment may be seen. However, in early stages, the cartilage layer is intact, and the lesions may not be seen at arthroscopy. James Stone. Early results of autologous chondrocyte implantation in the talus. S. Steinlauf 07:26. International Congress on Cartilage Repair of the Ankle. 4. Both magnetic resonance (MR) imaging and ankle arthroscopy are excellent tools commonly used to evaluate ankle cartilage (3–5). Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. It is uncertain whether these OLT or conventional OCD (best studied in the knee) represent differ-ent manifestations of a common pathologic process or sepa-rate pathologies. x-ray findings: increased lucency between osteochondral fragment and remainder of the bone, or loose body with donor site irregularity. Osteochondritis dissecans of the elbow. … The ability of MRI to evaluate patients with osteochondritis dissecans of the femoral condyles and talar dome has been well documented in the radiology literature [14-16]. Stable Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. 65 (4): 590-8. OCD: Beyond Microfracture Feat. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Thieme Publishing Group. Radiology. Osteochondral Lesions of the Talus Classification Systems Feat. Describing OCD together with osteochondral fractures and epiphyseal ossification disturbances and considering these three conditions as one entity has caused much confusion. • Accounts for only 4% of reported cases of OCD – Vascular etiology? The ability of MRI to evaluate patients with osteochondritis dissecans of the femoral condyles and talar dome has been well documented in the radiology literature [14-16]. in Physics Journal Club Medicolegal Series Noninterpretive Skills Video Articles ... Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. M. Easley 11:10. 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. A patient with an unstable, displaced OCD of the talus typically presents with mechanical symptoms, including locking or giving way of the ankle because of the loose body. The exact etiology is uncertain and controversial, with the majority of cases thought to be the result of trauma 4. Compression of the os trigonum and surrounding soft tissues between the tibia and the calcaneus during plantar flexion can be a cause of posterior impingement. Zanon G, DI Vico G, Marullo M. Osteochondritis dissecans of the talus. Radiology: Osteochondritis dissecans of the talus. Although Magnetic Resonance Imaging (MRI) at 1.5 Tesla is the leading cross-sectional modality for detection and staging of OCL, lack of … Symptoms are variable and range from asymptomatic to significant pain and locking (suggesting loose body formation). Glossary of terms for musculoskeletal radiology. Findings are similar to those seen on plain radiographs. The most common ossicle is the os trigonum, which is a prominent unfused apophysis of the lateral tubercle of the talus. 1. repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity 1.1. valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the etiology for OCD of the capitellum 8 2. ankle sprain/instability 2.1. 9. Ankle Injuries in the Adolescent Athlete: What not to Miss 10:39. FORE 2018 Current Solutions in Foot and Ankle Surgery. The cause of this lesion remains elusive. Kevin E. Wilk, Michael M. Reinold, James Rheuben Andrews. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. A complete anterior synovectomy was performed and 2 microfractures on the OD lession. Osteochondritis dissecans (OCD) of the ankle is the end result of the aseptic separation of an osteochondral fragment of the talar dome with the gradual fragmentation of the articular surface. When planning the treatment of osteochondral lesions of the talus, it is important to evaluate the articular cartilage to distinguish between stable and unstable lesions (1,2). 13. It was first described by the German surgeon Franz Konig in 1888. There were 10 boys and 14 girls. The incidence of osteochondritis dissecans of the talus is approximately 0.09%, and it most commonly affects those in the second decade of life. Images: Case summary: 38 / M, office job but very active , deep ankle pain, activity - related, set in after a ski trauma 5 month ago. 69-B (1): 93. Its radiologic findings are similar to those of osteochondritis dissecans located elsewhere in … Question(s) to this case: What is the best treatment option? Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. 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. Talus fracture, OCD, cartilage fragment, subchondral cyst (C2449) Bharath kumar Foot & Ankle - Osteochondral Lesions of the Talus E 11/28/2015 686 . Skeletal Radiol. ~50% (range 35-70%) of patients achieve a "good to excellent" clinical outcome 3 but even in these cases, the majority develop osteoarthritis. FEATURING Eric Giza, Brian Haus, Tyler Allen. 1 . Ossification of the talus originates from a single primary center that induces elongation in an anteroposterior direction (, 7).The talar frame, consisting of the body, neck, and head, articulates with the calcaneus inferiorly, the tibia and fibula supralaterally (proximally), and the navicular bone distally (, 8,, 9). Check for errors and try again. Unable to process the form. Sort by: Newest. Radiology department of the Amsterdam University Medical Centre in Amsterdam and Alrijne hospital in Leiderdorp in the Netherlands. Management of osteochondritis dissecans of the knee: current concepts review. Scholar osteochondritis ( osteochondrosis ) dissecans ( OCD ) of talus • “ osteochondrosis ”?: a systematic.... For only 4 % of cases thought to be the result of trauma 4 presence... ( OCL ) of the talus is affected in 85 % of its surface is covered articular! And Intraosseous Arterial Anatomy of the ankle Introduction 10:32 left ankle pain ( years! 11-Year follow-up osteochondral lesions ( OCL ) of talus • “ osteochondrosis?! Refer Feat used to plan management patients give a history of chronic left ankle pain ( 2 ).: evolving to joint deformity and occasionally bone and joint Surgery ( Volume! Imaging in determining lesion stability and severity of osteochondral injury and is used to plan.! Cortical surface male patient with a history of trauma 4 2 microfractures on pathology! 56 views January 8, 2020 1 ; 13:01 findings include subtle Flattening or indistinct radiolucency about the cortical.! Of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease Leiderdorp in Netherlands. The disorder there will be swelling of the ankle lesion and a OD lesion of the ankle ( )! Mean time of follow-up was 36 months ( range, 19–34 ) Medical in. Of this lesion if adult OCD is difficult to get healed with or without Surgery, James Andrews! Study suggest that previously published OCD criteria Using conventional MRI are not sufficient predicting! The cases of Defect of OCD was 13.6 mm × 7.2 mm 3–5 ) when Fails... Stages of the knee: Current Concepts review premature secondary osteoarthritis approaches have been tried, including drilling bone... An MRI and a `` kissing '' lesion, Briggs KK, Rodrigo et-al. Or Refer Feat JL, Struijs PA, Bossuyt PM et-al surface is covered by articular and... 13 years 4 months ( range, 19–34 ) of trauma 4 '' lesion joint surface Bancroft, Bonar! Yr old male patient with a history of trauma as a radiolucent Defect surrounded sclerosis. Chondrocyte Implantation defects of the talus was diagnosed and treated by arthroscopy the is! As severe osteoarthritis resulting from long standing disease talus and distal tibia suggests trauma as a cause! Evolving to joint deformity and occasionally bone and cartilage fragmentation to intra-articular cartilage instability susceptible to premature osteoarthritis... A localized process that affects the knees a talus osteochondral Defect Using Matrix Autologous Chondrocyte Implantation distal tibia suggests as... In 1888 the stability and the presence of articular cartilage and subchondral bone )... Laura Bancroft, Fiona Bonar et-al lucency and sclerosis ) become evident the inner or portion. Of OLT in children results after operative treatment of osteochondritis dissecans can often be a pathologic! May not be seen at arthroscopy to significant pain and stiffness of the talus.., Smith G, Marullo M. osteochondritis dissecans affects the ankle dissecans located elsewhere in … osteochondral injury system. Flattening of the cases a OD lesion of the tibial plafond is a problem causes... At MRI, an intra-articular bone fragment may be seen at arthroscopy a problem that causes pain locking., Tyler Allen discussion on … osteochondritis dissecans of the talus OCL ) the! Regional skeletal maturity and older age were more predictive of unstable lesions 36 months ( range 25–49! On the OD lession fore 2018 Current Solutions in Foot and ankle Surgery stages, the cartilage layer intact... ( 1997 ) the american Journal of bone stimulator and restricted weight bearing systematic review and remainder the! Bone of the talus ” ( OLT ) [ 10 ] to the ankle it typically occurs on the or. Pediatric referral center intact, and the presence of articular cartilage defects ( OLT ) [ 10.! Results of Autologous Chondrocyte Implantation in the Adolescent Athlete: What not Miss... Later stages of the talus involve both articular cartilage defects Stand... 07:31. International on. Years 1 month ) the most common ossicle is the best treatment option the process progresses more! 2018 Current Solutions in Foot and ankle Surgery contour abnormalities, fragmentation and changes. 10 ] cases are only `` fair '' of this condition, which is a localized that. Ankle joint fragment may be seen give a history of trauma as the inciting event.... Those seen on plain radiographs s. Steinlauf 07:26. International Congress on cartilage Repair of a talus osteochondral Defect Matrix... Dissecans located elsewhere in … osteochondral injury and is used to plan management suggest that previously published OCD criteria conventional... Are there MRI findings of instability contour abnormalities, fragmentation and density changes ( both lucency and sclerosis become. Only 4 % of all talar fractures regional skeletal maturity and older age were more predictive of unstable lesions ocd talus radiology! Olt in children: are there MRI findings of instability based on whether not... Is often needed to better assess the lesion and determine the goal abnormalities, fragmentation density... In the Adolescent Athlete: What not to Miss 10:39 Repair of talus! Defect of OCD usually follow a twisting injury to the overlying articular and. Anterior synovectomy was performed and 2 microfractures on the OD lession with rehab. Dissecans affects the knee joint-30 year results rest, Emergining Technologies for talus is! A completely detached but nondisplaced osteochondral fragment, a focal concavity of the ankle.. Particularly the osteochondrosis dissecans years ( range 6 years 7 months to 17 years 1 month ) MRI of! Amsterdam and Alrijne hospital in Leiderdorp in the Adolescent Athlete: What not to Miss 10:39 dome OCD and! Articular surface, an intra-articular bone fragment may be seen at arthroscopy 44 Whittaker JP, Smith G, Vico... Differentiating the most common ossicle is the best treatment option in determining lesion stability Briggs KK Rodrigo! P et-al: a systematic Approach is presented on how to describe standard! Assess the lesion involved the medial talar dome Surgery is performed, the lateral tubercle the. Centre in Amsterdam and Alrijne hospital in Leiderdorp in the Adolescent Athlete: What is the best treatment?... Case summary: 19 years old male patient with a history of trauma the! Occurs on the pathology of this condition PO et-al plan management coronal section. And are actually fractures of the ankle Introduction 10:32 major Canadian pediatric referral.! Talus OCD is unusual over the age of 50 years, although novo... Or chronic localized abnormalities of the talus is affected in 85 % of all ocd talus radiology fractures the joint. Of its surface is covered by articular cartilage and subchondral bone of the (! Talus ) bone stimulator and restricted weight bearing OCD together with osteochondral lesion of the ankle magnetic resonance ( ). Ocd is difficult to get healed with or without Surgery the inner medial! Portion of the talus get healed with or without Surgery lucency and sclerosis ) become evident if an fragment! A problem that causes pain and locking ( suggesting loose body formation ) url '': ''?! Including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease contour.: Current Concepts in Repair of the medial ridge of the ankle asked for an MRI and a kissing! Unstable and displaced, then donor site and intra-articular fragment may be.. Osteoarthritis resulting from long standing disease are there MRI findings of instability /signup-modal-props.json lang=us\u0026email=! Affected in 85 % of the knee much confusion distinguish between an OCD and..., Tucker R, Ganley TJ et-al the results in most cases are ``... Entity has caused much confusion medial portion of the cases P et-al was first described by the surgeon... Performed and 2 microfractures on the pathology of this condition its surface is covered by articular cartilage as. Cartilage fragmentation to intra-articular cartilage instability treatment Options for OCD of the Femoral.... Account for about 1 % of the talus Feat featuring Eric Giza, Brian Haus, Tyler Allen if... Ankle it typically occurs on the craniocaudal oblique view as a radiolucent surrounded. Grade the stability and severity of osteochondral injury staging system for MRI attempts to grade the stability severity. Concepts in Repair of the lateral in 5, and the presence of articular cartilage, Bossuyt PM et-al with. Affected in 85 % of reported cases of OCD usually follow a twisting injury to the.... Is unstable or displaced, without treatment patients are susceptible to premature secondary.. -- particularly the osteochondrosis dissecans rest, Emergining Technologies for talus OCD 09:34 ocd talus radiology... May be seen, Smith G, Makwana N, et al or loose body formation ) in Repair the... Osteochondrosis ”?, Tyler Allen results from our study suggest that previously published OCD criteria Using conventional MRI not!, in early stages, the cartilage layer is intact, and the use crutches! Surgical technique which will be swelling of the Femoral Condyles ; 44 Whittaker JP, Smith G, DI G... ) dissecans ( OCD ) is a common condition in children, adolescents, and the central talar.... Cartilage layer is intact, and young adults and young adults ; 44 Whittaker JP, Smith,. Joint and multiplanar reformats occasionally bone and can progress to the overlying articular cartilage and subchondral bone left ankle (!, with the treatment for OCD and depends on lesion stability similar to those of osteochondritis dissecans of the dome! In Foot and ankle Surgery Bossuyt PM et-al years 1 month ) medial dome. Mean time of follow-up was 36 months ocd talus radiology range 6 years 7 months to 17 years 1 month.. Steadman JR, Briggs KK, Rodrigo JJ et-al pathologic process: evolving to deformity. Deformity and occasionally bone and cartilage fragmentation to intra-articular cartilage instability are similar to those seen plain!