Osteochondritis dissecans (OCD) of the lateral talar dome

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Ankle twisting since one month with ankle pain swelling.

Patient Data

Age: 30 years
Gender: Female

Conventional radiographs shows subchondral lucency of the lateral talar dome with adjacent sclerosis.

  • The lateral talar dome shows marrow edema signal with patchy area of low T1 and high PD fat suppression and STIR signal intensity as well as subchondral irregular hypointense fracture line. Associated marrow edema signal of the talus body and neck is seen as well.
  • Intact collateral ligaments of the ankle.
  • Intact tendo-Achilles.
  • Minimal tibio-talar joint effusion.
  • A small lobulated 1.5 X 1 cm lesion is seen within the distal tibial metadiaphysis. It shows low T1 and high T2/GRE signal with intra-lesional focus of low signal in all pulse sequences.
  • Normal signal and girth of the peri-articular musculature with no soft tissue mass lesion.

Case Discussion

  • Lateral talar dome osteochondral lesion; consistenr with stage III osteonecrosis of the talar dome with bone marrow edema and subchondral fracture.
  • Minimal tibio-talar joint effusion.
  • Distal tibial metadiaphysis benign-looking lesion likely small enchondroma or intra-medullary infarction.

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Case Information

rID: 28556
Case created: 30th Mar 2014
Last edited: 16th Dec 2015
Inclusion in quiz mode: Included

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