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Osteochondral injury

Case contributed by RMH Core Conditions


Fall. Swelling and pain to lateral malleolus.

Patient Data

Age: 23
Gender: Male


No acute fracture identified. Normal alignment.

Lateral talar dome osteochondral defect, with adjacent 9 x 3 mm corticated bony fragment.

Bony deformity within the distal right fibula appears post-traumatic.

Prominent talar neck spur.

Soft tissue swelling adjacent to the lateral malleolus.


9 X 9 (axial) X 3 mm osteochondral fragment is demonstrated at the lateral aspect of the talar dome consistent with an intra-articular fracture. Two much smaller interarticular bony fragments. A small to moderate ankle joint effusion is demonstrated more pronounced in the lateral compartment of the ankle joint. The ankle mortice is overall maintained. No other fracture or subluxation is seen.

No CT evidence of diastasis of the distal tibiofibular joint suggestive of injury to the tibiofibular ligaments/interosseous membrane.

Well defined small lucencies in the lateral aspect of the distal fibula and deformity of the distal fibula are consistent with previous internal fixation of an old fracture. Prominent anterior talar neck spur noted.


Intra-articular osteochondral fracture of the talar dome as described.


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