Chondroblastoma of the talus

Case contributed by Dr Ralph Nelson

Presentation

Right foot pain and soft tissue mass with swelling in the right ankle from medial to lateral.

Patient Data

Age: 25 years
Gender: Male
X-ray

Well-defined lucent lesion with smooth margin and thin sclerotic rim at the head of the right talus. No internal calcified matrix. The lesion is less conspicuous on the lateral and oblique views. 

No other abnormality significant identified. 

Differential diagnostic consideration would include giant cell tumor, osteomyelitis and chondroblastoma. Further characterization with MRI recommended.

MRI

Well-circumscribed 24 x 14 x 16 mm ovoid lesion in the anterior inferior aspect of the right talus. The lesion is hyperintense on the fluid-related sequences, iso- to slightly hyperintense on T1. The lesion touches the inferior and anterior subarticular cortex of the talus. Although the lesion is spontaneously hyperintense on pre-contrast T1-Fat sat, there is moderate enchancement post-contrast injection. 

Extensive bone marrow edema at  and around the talus. 

No cortical break or associated pathological fracture. 

CT

Post curetage and bone grafting

Post curettage and bone grafting of the talar lesion.

The bone graft appears well incorporated.

No evidence of tumor recurrence. 

Case Discussion

The radiographic features of the lesion are consistent with a chondroblastoma. 

Tissue analysis of two right talar specimens from bone curettages confirms the diagnosis of chondroblastoma. 

At the time of publishing, a quick google survey of the literature demonstrates only one reported case study of a talar chondroblastoma. 

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