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It is important that you recognize the symptoms of a talar dome lesion because left untreated, damaged cartilage and bone can break off and float elsewhere in the ankle. Symptoms of a talar dome lesion include: Pain deep within the ankle; Pain that is worse when bearing weight; A clicking, catching or grinding sensation in your ankle when walking
The signs and symptoms of a talar dome lesion may include: Chronic pain deep in the ankle—typically worse when bearing weight on the foot (especially during sports) and less when resting. An occasional “clicking” or “catching” feeling in the ankle when walking. A sensation of the ankle “locking” or “giving out”.
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May 10, 2020 · Osteochondral lesion of the talar dome (OCLT) is a term that encompasses any injury to the articulating cartilage of the talus. The term OCLT was first described in 1887 by Konig and 35 years later, in 1922, another common name, osteochondritis dissecans of the talar dome, was coined by Kappis.
- Mitchell J. Thompson, Thomas S. Roukis
- 2020
- Conventional Radiography
- Computed Tomography
- Magnetic Resonance Imaging
- Arthrography
- What to Report?
CR remains useful in the initial workup in acute ankle sprains or deep ankle pain with suspected OCLs of the talar dome, and the evaluation should include anteroposterior and lateral weight-bearing and mortise views . Optional heel-rise views can improve the detection of OCLs. A routine radiological examination is unable to identify 30–50% of OCLs,...
The sensitivity and specificity of CT for the detection of OCLs are 81% and 99%, respectively . CT with axial slices and a thickness of 0.6 mm and sagittal reformations of 1 mm is suggested . Plantar flexion CT (patient in the supine position, with a slightly flexed knee and maximal plantar flexion, secured by a foot plate) can be performed in a pr...
MRI is the most appropriate method for the diagnosis of OCLs, with a sensitivity and specificity of 96% . Even though the evaluation of ankle cartilage is challenging due to its small thickness, curvature, and articular congruence, MRI allows the identification of cartilage lesions and degeneration, especially with strong magnetic fields , sequence...
Due to the low thickness of the articular cartilage and high congruence of the tibiotalar joint, the evaluation of cartilage defects can be challenging with conventional MR imaging. The use of intra-articular contrast may help to better delineate the cartilage surface and detect morphologic abnormalities. The high contrast and spatial resolution pr...
Location
Medial lesions account for almost 62% of OCLs, lateral lesions account for approximately 36% of OCLs, and only 1% of OCLs occur in the center-third of the talar dome [2, 33]. Lateral lesions are most likely posttraumatic (94%), while only 64% of medial lesions present a history of previous trauma . Lateral lesions are usually caused by shear stress and tend to be shallow and oval. On the other hand, medial lesions usually occur due to torsional impaction and axial loading, resulting in de...
Size
Since arthroscopic measurement of a lesion can be both inexact and challenging, the radiological approach is pivotal to assess the size of an OCL . When reporting the size of an OCL, the radiologist should always measure the lesion in 3 planes (anteroposterior, laterolateral, and depth). MRI is frequently used in daily routine practice but may overestimate lesion size; therefore, for surgical planning, we suggest CT for precise measurements.
Cartilage status
As previously noted, the evaluation of ankle cartilage can be challenging with conventional MRI studies, but it is fundamental to guide treatment decisions. The Outerbridge classification is an arthroscopic system first developed to stage cartilage lesions of the knee, and a correlation can be applied for imaging studies of the ankle as follows: grade 0, normal cartilage; grade 1, focal signal abnormalities; grade 2, surface irregularities or fraying; grade 3, partial thickness cartilage...
- Júlio Brandão Guimarães, Isabela Azevedo Nicodemos da Cruz, Caio Nery, Flávio Duarte Silva, Alípio G...
- 2021
The signs and symptoms of a talar dome lesion may include: Chronic pain deep in the ankle—typically worse when bearing weight on the foot (especially during sports) and less when resting; An occasional clicking or “catching” feeling in the ankle when walking; A sensation of the ankle locking or giving out Episodes of swelling of the ankle
A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage.
Aug 19, 2016 · Anatomy. Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. The medial lesions tend to be deeper and cup shaped whereas the lateral lesions tend to be thinner and more wafer shaped ( 2 ).
