Osteochondritis dissecans

Case contributed by Dr Hisham Alwakkaa

Presentation

Patient complains of right ankle pain with no history of trauma.

Patient Data

Gender: Female
X-ray

There is a focal lucency with sclerotic borders at the superomedial corner of the talar dome, best appreciated on the medial oblique (mortise) view, mostly consistent with an osteochondral defect (osteochondritis dissecans).

Additionally, there is moderate degenerative osteophyte proliferation at the dorsal aspect of the talonavicular joint, and an incidentally noted os trigonum. 

CT

There is an irregular, well-corticated bony fragment located at the the posteromedial corner of the talar dome. It appears to be detached from the donor bone but still lying within the defect. The appearance is consistent with osteochondral defect (osteochondritis dissecans). 

Additionally, there is an os trigonum, os calcaneus secundarius, and moderate degenerative osteophyte proliferation at the dorsal aspect of the talonavicular joint. 

Case Discussion

This is a case of osteochondritis dissecans with a typical clinical presentation (ankle pain with no significant trauma history) and typical radiological findings (subarticular detached fragment off the posteromedial talar dome). MRI was not obtained in our institution; however, the CT shows a stage III ostoechondral defect (detached fragment but not displaced).

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Case information

rID: 56354
Case created: 27th Oct 2017
Last edited: 29th Nov 2017
Inclusion in quiz mode: Included
Excluded from licensing
Institution: Women and children Hospital of Buffalo

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