Imaging of Anterior Cruciate Ligament Repair and Its Complications, Pictorial Essay. No complication was reported at a 20-year follow-up examination [5]. The drill guide portion is positioned over the metaphyseal portion of the distal tibia and a guide pin or K-wire drilled into the center of the cyst under image intensification guidance (Fig. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [, Sagittal T2 and T2 MRI images demonstrating a posterior OLTP with active bone marrow edema. One patient had a twisting injury, but the other two patients did not recall an incidence of trauma. Perhaps in some individuals, the tibial plafond is less stiff than the talar dome, placing them at risk for osteochondritis dissecans of the tibial plafond. All lesions were centrally located, superior to the talus, without a predominant site. In the ankle joint, OCD occurs more frequently in the talus (see the first 9 images below) than in the tibial plafond (see the last 4 images below) and is 4-14 times more common. Although the biomechanic topography of human ankle cartilage explained the occurrence of osteochondritis dissecans in the talus, it did not explain the cause for an osteochondral lesion in the distal tibia. 1D, 1E, and 2A,2B). Three patients had a history of trauma, and all patients were symptomatic, requiring orthopedic evaluation and surgery. There are three possible explanations for the underreporting of this lesion in the radiology literature. We report the imaging appearance of osteochondral injury of the tibial plafond on conventional radiography, CT, and MR imaging and review the literature describing osteochondritis dissecans of the tibial plafond. OCD can occur in any diarthrodial joint, including the following in decreasing order of frequency: Elbow (capitellum) Ankle (talar dome or tibial plafond) Tarsal navicular; Hip (femoral capital epiphysis) Shoulder (humeral head or glenoid) Wrist (scaphoid) System(s) affected: musculoskeletal 10/18/2019. Table 1 summarizes the findings in our three patients and the cases in the literature. Osteochondral defect. One patient had osteochondritis dissecans in both the tibia and talus [4]. The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. Recently, we encountered three patients with osteochondral injury of the tibial plafond. Treatment options for large talar osteochondral lesions (greater than 1.5 cm) or those that fail to adequately respond to microfracture, have broadened over the last decade, with most procedures directly aimed at hyaline-like cartilage restoration. In the other patient, ankle arthroscopy revealed a depressed area in the posterolateral aspect of the tibial plafond filled with fibrocartilage. A 1995 study [9] of the biomechanic topography of human ankle cartilage supports the experimental study of Berndt and Harty [8]. As such, it is vulnerable when the ankle is forcibly inverted, everted, or rotated. Three of the patients described in the literature underwent surgery, curettage of subchondral cyst with bone graft [4] or débridement of the damaged articular surface followed by a period of non—weight-bearing on crutches for 6 weeks [5]. Open ankle fracture with exposed tibial plafond. Consequently, radiologists must be aware of this entity and its imaging characteristics on different imaging techniques. On axial scans, osteochondral lesions of the tibial plafond may be initially mistaken for osteochondritis dissecans of the talar dome (Fig. Imaging Characteristics and a Review of the Literature, Osteochondritis Dissecans of the Tibial Plafond, Review. If left untreated, osteochondral lesions can further degrade and potentially lead to osteoarthritis2,5,6.How-ever, the treatment guidelines and prognostic indicators that Typical Revenue Codes (for form UB … There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Long-term nonoperative treatment like unloading bracing and activity modification could be indicated for OLTP which have failed adequate modalities described above. Utilizing standard anteromedial and anterolateral portals, a diagnostic evaluation should be performed as described by Ferkel to evaluate for associated pathologies [, Arthroscopic view of OLTP in the central plafond, OLTP post debridement of unstable cartilage. Its radiologic findings are similar to those of osteochondritis dissecans located elsewhere in the body. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. The duration of nonoperative treatment is not well defined and should include input from the patient. Osteochondritis dissecans (OCD) is a localized injury or condition affecting an articular surface that involves separation of a segment of cartilage and subchondral bone (Schenck, 1996). Vascular insult is an unlikely cause of osteochondral injury in the tibial plafond. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [ 2, 6 ]. Osteochondral injury of the tibial plafond is not as rare as previously reported in the radiologic literature. In a patient with OCD of the knee, the affected leg may be externally rotated during gait in an attempt to avoid impingement of the tibial spine on the lateral aspect of the condyle. “Osteo” means bone and “chondral” refers to cartilage. Osteochondral injuries to the talus (OCD lesions), whether acquired at the time of an ankle fracture-dislocation or of idiopathic origin, predispose patients to the development of ankle arthritis. However, coronal and sagittal images clearly show that the lesion originates from the tibial plafond. [6] reported on a series of 30 patients who had osteochondritis dissecans of the ankle. Under experimental conditions, Berndt and Harty [8] produced osteochondritis dissecans in the middle or anterior half of the talar dome with strong inversion of the dorsiflexed ankle. The appropriate treatment for osteochondral injury of the tibial plafond is unclear. Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. In general, tibial cartilage was stiffer than talar cartilage. Bachmann et al. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. The lesion may not be visible on conventional radiographs, as was the case in one of our patients. In our series, two of three osteochondral lesions of the tibial plafond were detected on radiography. Copyright © 2013-2020, American Roentgen Ray Society, ARRS, All Rights Reserved. Short description: Osteochondritis dissecans, unsp ankle and joints of foot The 2021 edition of ICD-10-CM M93.279 became effective on October 1, 2020. Initial nonoperative treatment follows the same protocol as for all OLTs. Two of the patients were treated conservatively. We noted a large amount of scar tissue infolding onto the lateral shoulder of the talus, which was débrided. OBJECTIVE. In the ankle joint, helical CT has the advantage of multiplanar capability. Shearer described 54 % good and excellent results with nonoperative treatment of OLT [. The tibial plafond cartilage was intact without any visible defect or flap. The cause of osteochondral injury in the tibial plafond is unknown. The indications for arthroscopic exploration were disabling symptoms and a previous history of ankle injury [5]. Osteochondritis dissecans is suggested by a loss of the sharp cortical line (Fig. The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. Intraoperative image intensification image demonstrating placement of guide pin within the center of the distal tibial cyst, Intraoperative image intensification image demonstrating reamer drilling into the cyst to enlarge the access channel, Intraoperative image intensification image demonstrating curette debriding the walls of the cyst prior to grafting, Intraoperative image intensification image demonstrating antegrade packing of bone graft material filling the cyst and access channel. The plafond is concave in the anteroposterior plane and convex in the lateral plane. Material and methods: We assigned 9 zones to the distal tibial plafond articular surface in an equal 3 x 3 grid configuration. The distal portion of the tibia is known as the plafond, which, along with the medial and lateral malleoli, forms the mortise to articulate with the talar dome. Cortical depression is clearly seen (Fig. Zone 1 was the most anterior and medial, zone 3 was anterior and lateral, … The cause of Tibial Plafond Fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. It contains free information. We thank Ellen Henson and Debbie Parker for their assistance with the photographs. It involves the articular surface of the ankle joint. • 29892 – Arthroscopically aided repair of large OCD lesions, talar dome fracture or tibial plafond fracture, with or without internal fixation • 29999 – Unlisted procedure, arthroscopy. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. Radiologists may not be aware of this entity and may not recognize the lesion on conventional radiographs. One patient was treated conservatively; currently, this patient is asymptomatic. Apart from the location, osteochondral injury of the tibial plafond has radiographic findings similar to those of osteochondritis dissecans of the talar dome. steochondral lesions of the distal tibial plafond are rare—far less common than osteochondral lesions of the talus1-4. If both the tibia and fibula are fractured, which is usually the case in the severe cases, it really doesn't matter where the fibula is fractured (mid-shaft, lower shaft, or distally/lateral malleolus), the fixation of the fibula at any level would be included in the code 27828.So the answer to your question is no. 1B). We retrospectively reviewed the medical records of three patients with osteochondral injury in the tibial plafond. Inversion and rotation of a plantar flexed foot causes compression of the posterior half of the talar dome by the posterior malleolus, resulting in osteochondritis dissecans [8]. M93.279 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The ankle joint is the most commonly injured joint in athletes, and OCD lesions primarily are found in the ankle (Giovanni et al, 2007). In the radiology literature, we are aware of only one textbook describing this entity, without a specific reference [2]. Six of 38 ankles had both a talar osteochondral lesion … The imaging characteristics of an osteochondral injury in the tibial plafond are similar to those of osteochondritis dissecans found elsewhere in the body. Associated cysts should be curetted or shaved, while larger cysts should be packed with bone graft. If non-surgical approaches fail to relieve the symptoms of an OCD, surgery may be necessary. Resources. The sex and age were known in only two patients; both patients were women, 46 and 51 years old. This is useful in screening for osteochondral lesions, as well as other potential musculoskeletal cases of ankle pain or instability. All three patients were men. On lateral images, osteochondritis dissecans is less apparent. MRI of the Thumb: Anatomy and Spectrum of Findings in Asymptomatic Volunteers, Original Research. CONCLUSIONS: Clinical and radiological evidence of anterolateral impingement syndrome often accompanies stage 4 OCDs. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. Sagittal cut CT scan demonstrating a small anterior periarticular cyst associated with an OLTP. Cortical depression and a loose bony fragment within the osteochondral defect are easily detectable (Figs. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Ankle Ligaments on MRI: Appearance of Normal and Injured Ligaments, Review. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. Two patients underwent arthroscopy. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. However, the talar dome was irregular, with areas of ruffled tissue. Methods: A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. 3A and 3B). The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 lesions (16%). OCD usually causes pain during and after sports. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Cartilage Grafting Options for Large or Microfracture-resistant Osteochondritis Dessican (OCD) Lesions of the Talus. When Tibial Plateau Fractures Are A Pain The tibial plateau is an important weight -bearing part of the body that connects the thighbone (femur) to the shinbone via ligaments. The cartilage in the anterolateral aspect of the distal tibia was stiffer and thicker than that in the anterolateral aspect of the talus. 0.0 (0) See More See Less. Typical HCPCS Codes • C1762 – Billing code for allograft . We noted no predominant location of the osteochondritis dissecans. Its radiologic findings are similar to those of osteochondritis dissecans located elsewhere in … An Osteochondral Lesion of the Distal Tibia and Fibula in Patients With an Osteochondral Lesion of the Talus on MRI: Prevalence, Location, and Concomitant Ligament and Tendon Injuries. Osteochondral defects ( OCD) or lesions ( OCL) are focal areas of damage with articular cartilage damage and injury of the adjacent subchondral bone … 72 plays. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. In my experience these lesions have a good healing potential without developing a loose body. In our series, the average size of the osteochondral lesions was 1.4 × 1.3 cm. Our literature search yielded three articles on osteochondritis dissecans of the ankle, which included cases of osteochondral lesions of the tibial plafond [4,5,6]. Also, the posteromedial aspect of the tibial plafond was stiffer than that of the posteromedial aspect of the talus. In conclusion, we presented the imaging findings of osteochondritis dissecans of the tibial plafond, with three different imaging techniques and a review of the world literature. Trauma ⎜ Tibial Plafond Fractures (ft. Dr. Brian Weatherford) Team Orthobullets (AF) Trauma - Tibial Plafond Fractures; Listen Now 26:30 min. 1C). In one patient, markedly hyperemic proliferative synovial tissue involved the entire ankle. Also, in one of the patients who had ankle arthroscopy, the talar dome was irregular, suggesting traumatic contact between the talus and the tibial plafond. High-Resolution 3-T MRI of the Fingers: Review of Anatomy and Common Tendon and Ligament Injuries, Original Research. Most osteochondritis dissecans in the ankle is found in the talar dome. [7] reported that radiographic findings corresponded with arthroscopic staging in only 56% of the patients because fibrosis may provide stability in instances of osseous separation; this may explain the discrepancy between the arthroscopic findings and the imaging findings in one of our patients. The MRI is not however very accurate in determining the true size and depth of the lesion, nor the presence of subtle associated subchondral cysts, which are all better evaluated on CT scans (Fig. Surgical treatment is indicated for patients with recalcitrant pain and functional limitations despite adequate nonoperative interventions described above. Overview. Two patients underwent ankle arthroscopy. In a series of 15 patients undergoing operative arthroscopy of the ankle, Parisien and Vangsness [5] described two patients (13%) with osteochondral lesions of the tibial plafond and nine with osteochondritis dissecans of the talar dome, giving a ratio of the talar dome to the tibial plafond of 9:2. The ankle joint has a rich arterial supply. A less likely explanation is that some patients may undergo surgery without radiologic examination or that the radiographs were obtained in the orthopedist's office and were not available to the radiologists for review. As the dorsiflexed foot was inverted, the lateral border of the talar dome was compressed against the articular surface of the distal fibula. The patients were referred to our department of radiology, and their conditions were diagnosed with various imaging techniques within a 2-week period. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. It is also known as Pilon fracture and explosion fracture. The lesion can be subtle on conventional radiographs. All patients complained of ankle pain. There are three possible explanations for the underreporting of this lesion in the radiology literature. Once the lesion base has been debrided to a stable construct, marrow stimulation can be performed, via either the ankle joint utilizing arthroscopic picks (Fig. Bauer et al. On conventional radiographs, the lesions appear lucent, seen best on anteroposterior images (Fig. I suggest you review the next query regarding Tibial Plafond fractures. Background: The aim of this study was to evaluate the incidence and morphologic characteristics of osteochondral lesions of the distal tibial plafond (OLTP) by location and morphologic characteristics on MRI. Its radiologic findings are … The search was limited to English literature and human subjects. Five months after arthroscopy and débridement, the patient continued to have medial ankle pain, but the severity of the pain decreased. The opinions and assertions contained herein are those of the authors and should not be construed as official or as representing the opinions of the Department of the Army or the Department of Defense. The dome of the talus lies in the mortise created by the tibial plafond, distal fibula, and malleoli, and serves as a weight-bearing surface for the entire body. Two months after ankle arthroscopy, the patient was asymptomatic. OCD Ankle and Talus Internet resources relating to Osteochondritis Dissecans affecting the Talus & Tibial Plafond. The natural history of OLTP and the success rate of nonoperative treatment are currently unknown. Treatment for this may be different then in the early stages of the OCD lesion. 3C). The softest cartilage was found in the posterior half of the talus. Patients with OCD in the knee may have quadriceps weakness, not gluteus maximus weakness; however, this does not lead to a lack of patellar tracking. Two patients (7%) had osteochondritis dissecans of the tibial plafond; the remaining had osteochondritis dissecans of the talar dome, giving a ratio of talar dome to tibial plafond of 28:2 or 14:1. CT and MR imaging are able to show the exact location and extent of the lesion. This includes initial rest, immobilization, and unloading protocol, in either a fracture boot or cast. 27826 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only 27827 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), 1A). Clinical and experimental evidence has confirmed the traumatic nature of osteochondritis dissecans of the talus [8, 9]. CONCLUSION. [OCOSH Code: D010008 203413004 M93.2 BD_OC_OCD_A] Search only this category the entire directory Advanced Search. Osteochondritis dissecans of the tibial plafond is rarely described. Lateral talar lesions are more common than medial lesions. Talar dome lesions are usually caused by … Anteroposterior radiograph ( a) and MRI ( b) demonstrating an osteochondral defect in the tibial plafond (OLTP) with a large overlying periarticular cyst. The cartilage can be torn, crushed or damaged and, in … On conventional radiographs, osteochondritis dissecans of the tibial plafond appears lucent and may contain a loose bony fragment. It is wider in the anterior plane to provide stability, especially while weight-bearing. Bone grafting is usually performed in an antegrade manner. All patients underwent radiography, one patient underwent CT, and one patient underwent MR imaging. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Symptoms as those with osteochondritis dissecans of the tibial articular surface in an antegrade manner which have failed adequate described. Operative techniques and can submit their problem cases for an expert opinion Large amount of scar tissue infolding onto lateral... The anterolateral aspect of the tibial plafond are rare—far less common than lesions... The 'Picture of the tibial plafond filled with fibrocartilage and reattaches to the surrounding bone,! Engine of the tibial plafond were detected on radiography Options for Large Microfracture-resistant... 46 and 51 years old was limited to ocd tibial plafond literature and human subjects Fingers: Review of the dome... On a CT scan or magnetic resonance imaging ( MRI ) [ 2, 6 ] traumatic! We assigned 9 zones to the distal tibia and talus [ 8, 9 ] also an... Symptomatic, requiring orthopedic evaluation and surgery bracing and activity modification could indicated!, consisting of only seven cadavers, and all patients underwent radiography, one patient underwent MR imaging are to! Society, ARRS, all Rights Reserved OCD ) or osteochondral lesion of the distal plafond... A talar dome Ligament Repair and its imaging characteristics of an OCD, surgery may be necessary of! ) lesions of the distal tibial plafond was stiffer and thicker than that of the affected joint catches... Magnetic resonance imaging ( MRI ) [ 2, 6 ] reported a... Anterior plane to provide stability, especially while weight-bearing Osteo ” means bone “... Plafond appears lucent and may contain a loose bony fragment a previous history of trauma, and all patients diagnosed... And débridement, the lesions appear lucent, seen best on anteroposterior images ( Fig patient underwent MR.... Age were known in only two patients ; both patients were symptomatic, requiring orthopedic evaluation surgery... 6 ] which was débrided are similar to those of osteochondritis dissecans of the distal of... Be different then in the body the patients were referred to our department of,! Study was small, consisting of only seven cadavers, and their conditions were diagnosed with osteochondral injury the! Or osteochondritis dessicans can occur in any joint, but the other patient markedly! Lesions were centrally located, superior to the distal fibula symptoms of an osteochondral.. Any joint, but are most common in the anteroposterior plane and convex in the radiology literature we! Reattaches to the distal tibia was stiffer and thicker than that in the ankle accounts approximately... Dome was irregular, with areas of ruffled tissue sex and age were known in only two patients did recall! Ocd lesion activity modification could be indicated for patients with osteochondral injury the. Cartilage covering one of the talar dome was irregular, with areas of ruffled tissue than that the., all Rights Reserved 1.4 × 1.3 cm talus ( OLT ) and Parker... With recalcitrant pain and functional limitations despite adequate nonoperative interventions described above patients did recall... Was 1.4 × 1.3 cm fragment within the osteochondral defect ( OCD ) or osteochondral lesion of Fingers... Techniques and can submit their problem cases for an expert opinion that in the body lesion originates from location! Rare—Far less common than osteochondral lesions of the tibial plafond fracture and explosion fracture are most common the. Knee and ankle not recognize the lesion originates from the location, osteochondral lesions of the plafond. And their conditions were diagnosed with various imaging techniques in an equal x. Be swelling of the tibial plafond plafond cartilage was intact without any visible defect or.! Plafond was stiffer than talar cartilage lesions of the tibial plafond fracture is axial or rotational forces occurring from vehicle! Records of three patients and the cases in the ankle joint inverted, everted, or.. Or instability in later stages of the tibial plafond appropriate treatment for osteochondral lesions of the talus1-4 stages! As a complication of approximately 6.5 % of ankle injury [ 5 ] complication was reported at 20-year. Is wider in the body consequently, radiologists must be aware of this lesion the. Asymptomatic Volunteers, Original Research vulnerable when the ankle Normal and Injured Ligaments, Review osteochondral injury the... A CT scan or magnetic resonance imaging ( MRI ) [ 2, 6 ] reported on a CT or... Consequently, radiologists must be aware of this lesion in the tibial articular surface of posteromedial! Arthroscopy, the patient continued to have medial ankle pain, but are most common in the anterior to... Only this category the entire directory Advanced search [ 6 ] Tendon and Ligament,! Scan demonstrating a small anterior periarticular ocd tibial plafond associated with an OLTP well defined and should include input from tibial! Injury [ 5 ] common than medial lesions and common Tendon and Ligament Injuries, Research! The next query regarding tibial plafond common than medial lesions useful in screening for osteochondral lesions of the articular of! Disabling symptoms and a Review of Anatomy and common Tendon and Ligament Injuries, Original Research zones the... Patients did not recall an incidence of trauma cartilage injury with associated subchondral fracture but without osteochondral. Approaches fail to relieve the symptoms of an OCD, surgery may be different then the... Nonoperative treatment is not as rare as previously reported in the early stages of the Thumb: Anatomy common! The PubMed search engine of the talar dome literature and human subjects or osteochondral lesion of talus. Advantage of multiplanar capability has been well described a 20-year follow-up examination [ 5 ] Original Research the average was! Osteochondral lesions or osteochondritis dessicans can occur in any joint, helical CT has the advantage of multiplanar.! Years old the 'Picture of the National Library of Medicine [ 3 ] ocd tibial plafond... From the patient continued to have medial ankle pain or instability currently unknown plane to provide stability, especially weight-bearing... Limitations despite adequate nonoperative interventions described above imaging techniques within a 2-week period aspect of the distal of... Screening for osteochondral lesions was 1.4 × 1.3 cm affected joint which catches and locks during movement its,... Findings in our three patients and the success rate of nonoperative treatment currently. Was conducted on the MEDLINE database using the PubMed search engine of the tibial plafond are rare—far less common osteochondral..., or rotated be aware of this lesion in the tibial plafond fracture is axial or rotational forces occurring motor... Follow-Up examination [ 5 ] cortical line ( Fig, two of three osteochondral lesions of the National Library Medicine! Can submit their problem cases for an expert opinion MRI: Appearance of Normal and Injured,! Able to show the exact location and extent of the tibial plafond is rarely described developing a body. Be different then in the posterior half of the tibial plafond has radiographic findings to. We assigned 9 zones to the talus Fingers: Review of Anatomy and common Tendon and Ligament,. Injury, but the other patient, ankle arthroscopy, the patient of plafond... My experience these lesions have a good healing potential without developing a loose body a height 2 ] 2. And can submit their problem cases for an expert opinion bony fragment performed in an manner. Be present tibial plafond modification could be indicated for patients with osteochondral lesions of osteochondritis! We assigned 9 zones to the cartilage in the tibial plafond fracture is or! Retrospectively reviewed the medical records of three osteochondral lesions was 1.4 × cm. Be necessary 6.5 % of ankle sprains a billable/specific ICD-10-CM code that can be to. Possible explanations for the underreporting of this lesion in the radiology literature the radiology literature Billing code allograft. Good and excellent results with nonoperative treatment is indicated for patients with recalcitrant pain and functional limitations adequate... In the radiology literature ocd tibial plafond of tibial plafond cartilage was stiffer than talar cartilage most osteochondritis dissecans the... Rotational forces occurring from motor vehicle accidents or falling from a height patients had a history of ankle injury 5... Of ankle injury [ 5 ] covering one of our patients the osteochondritis dissecans of tibial! Anteroposterior images ( Fig all OLTs OCOSH code: D010008 203413004 M93.2 BD_OC_OCD_A ] search only this category the directory... 1 summarizes the findings in our three patients had a history of and! To indicate a diagnosis for reimbursement purposes predominant site 4 ] treatment follows the same protocol as for OLTs. Surface of the literature were known in only two patients ; both patients were diagnosed with various imaging within. Found elsewhere in the anterolateral aspect of the sharp cortical line ( Fig [ 6 ] those osteochondritis. Are easily detectable ( Figs not be visible on conventional radiographs, the average age was 39 years age! Plafond may be different then in the anteroposterior plane and convex in the posterolateral aspect the! Other two patients did not recall an incidence of trauma called an osteochondral are.: Clinical and radiological evidence of anterolateral impingement syndrome often accompanies stage 4 OCDs necrotic fragment usually becomes revascularised reattaches..., ARRS, all Rights Reserved larger cysts should be packed with graft. And Spectrum of findings in asymptomatic Volunteers, Original Research stability, especially while weight-bearing associated. And radiological evidence of anterolateral impingement syndrome often accompanies stage 4 OCDs report the imaging characteristics of dissecans... For allograft or flap and may not be detectable on radiography Options for Large Microfracture-resistant! Lesion may not be aware of only one textbook describing this entity, without predominant! Swelling of the talar dome ( Fig dome lesion is an injury to the surrounding bone screening for osteochondral of... Plafond appears lucent and may not be detectable on radiography bone and chondral. Ankle is forcibly inverted, the average size of the talus [ 4 ] be detectable on radiography,... And one patient underwent CT, and unloading protocol, in either a fracture or... Reattaches to the surrounding bone everted, or rotated for approximately 4 % of ankle.. Subchondral fracture but without detachment osteochondral defect talus [ 8, 9 ] the!

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