Talar osteonecrosis and os subfibulare

Case contributed by Dr Ahmed Abd Rabou

Presentation

Ankle pain and limitation of movement especially in plantar flexsion

Patient Data

Age: 50 years old
Gender: Male
Modality: MRI

An osteochondral injury to the medial aspect of superior surface of the talus with double line sign and bone marrow edema of he rest of the talus. An accessory bone is seen anterior to the distal fibula just inferior to the tibiofibular ligament and within the talofibular ligament indicating Os subfibulare. Also there is tenosynovitis of the flexor hallucis longus.

Case Discussion

Os subfibulare is an accessory bone seen anterior to the tip of lateral malleolus. It is believed to be either an accessory os or due to avulsion of the talofibular ligament. Osteochondral defect is common at the talar dome and believed to be due to avascular necrosis or repeated microtrauma leading to osteochondritis dessicans.

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Case Information

rID: 28977
Case created: 24th Apr 2014
Last edited: 4th Oct 2016
Inclusion in quiz mode: Included

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