Osteochondral Lesion of the Talus - MSK Radiology
Imaging Findings:
 • Typical location of the osteochondral defect along the medial talar dome with subchondral lucency on x-ray and surrounding sclerosis on Tl -sequence.
 • Linear T 2-hyperintense fluid-signal rim at the interface between the fragment and parent bone which is not detached. (Berndt & Harty staging: Fragment incompletely undercut by fluid signal → stage 11b)
Synonyms:
 • Osteochondral lesion: umbrella term for focal articular cartilage and cortical injury.
 • Osteochondral injury: used for acute/subacute lesions
 • Osteochondritis dissecans: chronic osteochondral defect
MOST IMPORTANT: Size of defect and assessment of stability
Unstable lesion MR findings:
 • Fluid (T2-signal) extends completely around fragment
 • Fluid-filled cysts deep to lesion
Differential diagnosis:
 • Avascular necrosis (serpentine line, normal cartilage until late), Osteoarthritis, Subchondral Insufficiency Fracture (SIF)

Dr. Donald von Borstel @DrvonBorstel

#Osteochondral #Lesion #clinical #mri #clinical #Radiology #diagnosis #msk