Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Osteochondral ankle defects involve articular cartilage and subchondral bone, often resulting from supination trauma.
• These injuries typically affect the talus and require accurate assessment for effective management.

Purpose of the Study:

• To review the role of various imaging modalities in diagnosing, planning surgery for, and monitoring osteochondral ankle defects.
• To compare the effectiveness of different imaging techniques in evaluating these specific injuries.

Main Methods:

• Review of current concepts regarding imaging modalities for osteochondral ankle defects.
• Discussion of conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, and single photon emission CT (SPECT).

Main Results:

• Conventional radiographs have limited sensitivity for detecting osteochondral defects.
• CT excels in defining bony lesion size and location; MRI visualizes cartilage and subchondral bone damage but may overestimate defect size due to edema.
• CT with plantar flexion is reliable for surgical planning; postoperative imaging assesses repair and degenerative changes.

Conclusions:

• Multiple imaging modalities are essential for comprehensive management of osteochondral ankle defects.
• CT and MRI are more accurate than plain radiography, with specific strengths for bony versus soft tissue evaluation.
• Imaging is critical for preoperative planning, surgical approach, and postoperative assessment of treatment outcomes.