Osteochondritis dissecans of the ankle
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There is a curvilinear subcortical lucency between a thin ossific density and the remaining taler dome. There is minimal anterior ankle soft tissue swelling. Findings are consistent with osteochondritis dissecans of the talus.
The osteochondral fragment (white arrow) projects into the lateral ankle joint space (visualized on frontal and oblique views as well).
The talar pathology was missed on a prior radiograph. The patient continued to have pain and a repeat radiograph (above) was performed. The osteochondral fragment can become a free intra-articular loose body. Surgery is performed to prevent secondary osteoarthritis.
This is an example of type 3 osteochondritis dissecans.