2001;219 (1): 35-43. Osteochondral defects of the talus (OCD) are a well-established pathology within the ankle. Characterizing osteochondral lesions by magnetic resonance imaging. DOI: https://doi.org/10.1155/2016/3594253, Posadzy, M., Desimpel, J. and Vanhoenacker, F.M., 2017. Diagnostic value of CT arthrography for evaluation of osteochondral lesions at the ankle. Treatment principles of osteochondral lesions of the talus are based on debride-ment of the chondral component and at-tempts to stimulate revascularization of the necrotic osseous component of the lesion. DOI: https://doi.org/10.1016/j.fas.2013.10.005, https://doi.org/10.2106/00004623-198668060-00007, https://doi.org/10.1007/s00256-015-2127-3, https://doi.org/10.2106/00004623-195941060-00002, https://doi.org/10.1177/107110079902001206, https://doi.org/10.1016/0749-8063(91)90087-E, https://doi.org/10.2106/00004623-198971080-00004, https://doi.org/10.1007/s00167-008-0607-x, https://doi.org/10.1007/s00330-006-0446-4, https://doi.org/10.1148/radiol.2333031921. Coronal reformatted CBCT-A (c) barely shows subtle subchondral sclerosis at the superolateral aspect of the talar dome and intact overlying cartilage. Osteochondral lesions of the talus: A new magnetic resonance grading system with arthroscopic correlation. Due to the widespread use of fluid-sensitive sequences on MRI, even subtle foci of BME may be seen adjacent to a cartilage defect, particularly in acute or subacute OCL lesions. and Dr. Arthemizio Antônio Lopes Rocha M.D. 2 of 7 Posadzy et al: Staging of Osteochondral Lesions of the Talus Figure 1: Location of the OCL according to the mechanism of trauma. The passive navigation concept is potentially applicable to many MR-guided interventions, and it may be an alternative to other navigation methods. 22 (4): 765-74. Figure 1: Berndt and Harty classification for talus, osteochondritis dissecans surgical staging, Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, pattern of bone contusion in knee injuries, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, musculoskeletal manifestations of rheumatoid arthritis, rapidly destructive osteoarthritis of the hip, scaphotrapeziotrapezoidal (STT) arthritis, calcium pyrophosphate dihydrate deposition disease, hydroxyapatite crystal deposition disease (HADD), postsurgical (e.g. Coronal (c) and sagittal (d) reformatted CBCT-A show a focal bony lesion with peripheral sclerosis in the distal tibia and talus. MRI allows for distinguishing normal cartilage from subchondral bone as well as evaluating the adjacent bone marrow, ligaments and other surrounding soft tissues (Figure 2c). Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology, 101(S2), 1. The articular cartilage layer of the talocrural joint is indicated in blue. Osteochondral lesions of the talus present a numerically small but therapeutically significant problem to the foot surgeon. You JY(1)(2), Lee GY(1)(3), Lee JW(1), Lee E(1), Kang HS(1). A comparison of arthroscopic and MRI findings in staging of osteochondral lesions of the talus. DOI: https://doi.org/10.2106/00004623-198971080-00004, Lee, KB, Bai, LB, Park, JG and Yoon, TR. S2, 2017, p. 1. DOI: https://doi.org/10.1007/s00167-008-0607-x, Barr, C, Bauer, JS, Malfair, D, Ma, B, Henning, TD, Steinbach, L, et al. Stage 3 according to Anderson classification. An alternative MRI staging system has been proposed by Mintz [8] et al. The authors have no competing interests to declare. Chronic osteochondral lesion of the talus after ankle trauma. There is slight irregular delineation of the cartilage (white arrow). 2006;187 (5): 1332-7. Osteonecrosis can develop when the lesion’s vascularity is disrupted. Past history of trauma. It combines high spatial resolution, relatively low radiation dose and low equipment cost and is useful for evaluation of trauma of small bones and joints, particularly when there is clinical suspicion for a fracture despite negative plain radiographs [3]. Compared to the articular cartilage of the knee, cartilage of the ankle joint is very thin and the spatial resolution of MRI may be insufficient for detection of small lesions. 4. Maya Patel1 & Michael L. Francavilla2,3 & J. Todd R. Lawrence3,4 & Christian A. Barrera2 & Michael K. Nguyen2 & Cruz Longoria5 & Jie C. Nguyen2,3 Received: 12 January 2020 /Revised: 23 March 2020/Accepted: 30 March 2020 3. 3 c Department of Radiology, Asan Medical Center, College of Medicine , University of Ulsan , Seoul , Republic of Korea. 2 of 7 Posadzy et al: Staging of Osteochondral Lesions of the Talus Figure 1: Location of the OCL according to the mechanism of trauma. Am J Sports Med. Vira S(1), Ramme AJ(1), Chapman C(2), Xia D(3), Regatte RR(4), Chang G(5). SCIENTIFIC ARTICLE Osteochondral lesion of the talus in children: Are there MRI findings of instability? The diagnosis and investigation of such lesions have been greatly enhanced by modern high resolution magnetic resonance imaging capabilities, which have provided far greater detail of the pathological anatomy. Foot Ankle Surg 2012;51:556-60. CBCT-Arthrography (CBCT-A) of the talocrural joint, coronal reformatted image (d) showing smooth cartilage lining covering the normal subchondral bone of the talus (arrow) and tibia (arrowhead). Sirlin CB, Brossmann J, Boutin RD et-al. Down staging of an OCL on CBCT compared to MRI. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by … A… Background and purpose - The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. The cartilage at the talar dome is slightly irregularly delineated (white arrow). C = cuneiform bone, Cal = calcaneus, Cu = cuboid bone, F = fibula, M = metatarsal bones, N = navicular bone, Ph = phalanges, STJ = posterior facet of the subtalar joint, Tb = talar body, TD = talar dome, Th = talar head, Ti = tibia, Tn = talar neck. The most common sites are the posteromedial (53%) ( Fig. Journal of the Belgian Society of Radiology, vol. “Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT”. Author information: (1)Department of Orthopedic Surgery, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Republic of Korea. The authors developed a minimally invasive method with computer-assisted navigation for retrograde drilling of osteochondral lesions of the talus. Characterizing osteochondral lesions by magnetic resonance imaging. Case contributed by Dr Vinay Shah. Cartilage thickness in cadaveric ankles: Measurement with double-contrast multi-detector row CT arthrography versus MR imaging. Osteochondral Defect Monday, September 15, 2008 MRI, Musculoskeletal MRI, Musculoskeletal radiology. CT arthrography visualizes tissue growth of osteochondral defects of the talus after microfracture. (2)Department of Radiology, Konkuk University School … Causes: Talar dome lesions are usually caused by an injury, such as an ankle sprain. It is often used synonymously with osteochondral injury/defect and in the pediatric population. Osteochondral Lesions of the Talus Sara Lyn Miniaci-Coxhead, MD Dr. Miniaci-Coxhead or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March 1, 2011, and May 31, 2018. The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. Retrograde drilling of osteochondral lesions of the medial talar dome. Figure 1. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. Pain in right ankle joint. In adult patients, the depth of the cartilage lesions is often understaged (Figures 3 and 4). • Goh GSH et al. Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A Clinical and Radiological 2- to 8-Year Follow-up Study. Accurate staging of cartilage lesions is of utmost importance, as this will have a major impact on the treatment strategy and ultimate prognosis. On the other hand, although MRI a very useful and sensitive technique for evaluation of the subchondral compartment (showing either BME or cyst formation), the precise depth and extent of the overlying cartilage lesion is often not accurately staged. Point loading and loose bodies cause a synovitis, and the mechanics of the joint are altered. 1. Arthroscopy. 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. CBCT following intra-articular injection of Iodine contrast (CBCT-Arthrography) may render exquisite detail of the articular cartilage using very thin slices and multiplanar reformation. Osteochondral autograft transfer involves harvesting single or multiple cylindrical cartilage and subchondral bone grafts from the non-weight-bearing part of the ipsilateral knee and transplanting them into the talar defect after preparation. The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. Pioneer in Rad Blogging. The purpose of this study was to directly compare the MRI with the arthroscopic findings. Materials and method: This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March … 2017;101(S2):1. Journal of the Belgian Society of Radiology 101, no. following anterior cruciate ligament repair), femoral condyle (most common in the lateral aspect of the medial femoral condyle), the signal is variable with intermediate to low signal adjacent to fragment and variable fragment signal, low signal loose bodies, outlined by high signal fluid, donor defect filled with high signal fluid. Patient Data. Coronal proton density (b) shows focal hypointense thickening of the talar dome (arrow). Sanders TG, Paruchuri NB, Zlatkin MB. DOI: https://doi.org/10.1053/jars.2003.50041, Anderson, IF, Crichton, KJ, Grattan-Smith, T, Cooper, RA and Brazier, D. Osteochondral fractures of the dome of the talus. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy M, Desimpel J and Vanhoenacker FM, ‘Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT’ (2017) 101 Journal of the Belgian Society of Radiology 1 DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, Magdalena, Julie Desimpel, and Filip M. Vanhoenacker. J Bone Joint Surg Am. Skeletal Radiol. Recht MP, Kramer J. MR imaging of the postoperative knee: a pictorial essay. Moreover, despite several modifications of the staging systems on MRI, not all combination of the degree of involvement of the cartilage and subchondral bone are included and therefore these classification systems remain uncomprehensive, complicated and less valuable for use in daily routine. Example of improved visualization of communication of subchondral cysts with the joint through deep articular cartilage lesions on CBCT arthrography. Purpose: The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. Eur Radiol. 1, pp. 1991;7:101– 104. Coronal (b) and sagittal (c) reformatted CBCT-A show subtle subchondral sclerosis (black arrow) at the superolateral aspect of the talar dome, but the overlying cartilage is intact. September 2018, Volume 15, Issue 3. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). On CBCT arthrographic images, the contrast separating the OCL fragment from the talar dome can be evaluated with more confidence (Figure 8). Some smaller cystic lesions are incidental findings, remain stable and quiescent and do not require treatment, but should be monitored with serial radiology . Stage 2 refers to partial detachment of OCL with subchondral cyst formation or fissure incompletely separating the lesion from the talar dome. Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology, 101(S2), p.1. Commonly, this is achieved by drilling the subchondral bone (6 – 12). This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March 1, 2011, and May 31, 2018. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. OLTs have been known historically by varied nomenclature, including osteochondritis dissecans, talar dome fracture, transchondral fracture, and flake fracture. In 10 cadavers and four patients, accuracy of pin placement was in the range of 1.0–3.5 mm. CBCT, which was first introduced for preoperative evaluation of dental implants, is currently also used for musculoskeletal applications. DOI: https://doi.org/10.1016/j.fas.2013.10.005, Pritsch, M, Horoshovski, H and Farine, I. Arthroscopic treatment of osteochondral lesions of the talus. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. S2 (2017): 1. Radiology. In particular cases also alternative diagnoses can be made on basis of CBCT (Figure 11). Coronal PD fat suppressed MRI image (b) revealing BME (star) in the posteromedial part of the talar dome. “Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT”. We report the outcome of a nonoperative treatment for symptomatic OCL. Lateral radiograph shows the normal skeletal anatomy of the foot and ankle. 2017. 2003; 19(4): 353–9. ObjectiveTo determine the role of magnetic resonance imaging (MRI) MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 1 and 2.0 scores in the assessment of … For staging of OCL of the talus several grading systems have been proposed. Stage 1 lesion according to Anderson classification. Open mosaicplasty in osteochondral lesions of the talus: a prospective study. • Goh GSH et al. 1991; 7(1): 101–4. Although it is adopted for osteochondral abnormalities of the talus (1), the term lacks specificity and should be only part of a description of a more specific diagnostic entity. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. When the latter is present, then joint replacement is often the only feasible treatment. Published: September 2018 . In this regard, CBCT-Arthrography (CBCT-A) may be very promising technique for precise staging of cartilage lesions of the ankle as an alternative for Multi Detector Computed Tomography (MDCT). Osteochondral lesions of the talus present a numerically small but therapeutically significant problem to the foot surgeon. With the advent of MRI, this grading system was further revised including evaluation of structures invisible on conventional radiology, such as the integrity of the cartilage and presence of BME. MRI of osteochondral defects of the lateral femoral condyle: incidence and pattern of injury after transient lateral dislocation of the patella. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Alternative diagnosis on CBCT compared to MRI. DOI: https://doi.org/10.2106/00004623-195941060-00002, Hepple, S, Winson, IG and Glew, D. Osteochondral lesions of the talus: A revised classification. It contains free information. Osteochondral lesions ... radiology, and sports medicine literature. Juvenile Particulate Osteochondral Allograft for Treatment of Osteochondral Lesions of the Talus: Detection of Altered Repair Tissue Biochemical Composition Using 7 Tesla MRI and T2 Mapping. It is often used synonymously with osteochondral injury/defect and in the pediatric population. They require a strong plan. 1989; 71(8): 1143–52. Stage 4 consists of a displaced fragment, often accompanied with surrounding bone marrow edema. Foot Ankle Int 1999; 20:474-480. The overlying cartilage is difficult to assess on MRI but seems to be slightly inhomogeneous (white arrow). Knee Surg Sports Traumatol Arthrosc. Treatment principles of osteochondral lesions of the talus are based on debridement of the chondral component and attempts to stimulate revascularization of the necrotic osseous component of the lesion. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6. Osteochondral Lesion of the Talus (OLT) Tracey A. Littrell, DC, DACBR, DACO, CCSP. Osteochondral lesions of the talus (OLTs) are lesions of the articular cartilage of the talus and underlying subchondral bone. The purpose of this pictorial review is to illustrate the strength of each imaging method. Cone Beam Computed Tomography (CBCT) arthrography is better suited for precise staging of cartilage lesions. Subchondral bone involvement can be manifested by bone marrow edema (BME), fracture, sclerosis and/or cyst formation. MRI. Arthroscopic treatment of chronic osteochondral lesions of the talus: Long-term results. Foot Ankle Int. Lesion size, location, chronicity, and characteristics such as displacement and the presence of subchondral cysts help dictate the appropriate treatment … J Bone Joint Surg Am. Direct comparison of conventional radiography and cone-beam CT in small bone and joint trauma. DOI: https://doi.org/10.1148/radiol.2333031921, Kirschke, JS, Braun, S, Baum, T, Holwein, C, Schaeffeler, C, Imhoff, AB, et al. Check for errors and try again. Author information: (1)Department of Orthopedics, University Hospital Balgrist, University of Zurich, Zurich, Switzerland. Diagnosis certain Diagnosis certain . Posadzy M, Desimpel J, Vanhoenacker FM. 1 ) and anterolateral (46%) talar dome ( 1 ). 1999; 20(12): 789–93. The equipment is designed to perform exams in sitting or supine position and is relatively compact, allowing installation in many radiology departments and private practices. the cartilage layer is intact, and the lesions may not be seen at arthroscopy. Coronal fat suppressed T2-WI (intermediate weighting) showing BME (white asterisk) at the lateral corner of the talar dome (a). DOI: https://doi.org/10.1177/107110079902001206, Ferkel, RD, Zanotti, RM, Komenda, GA, Sgaglione, NA, Cheng, MS, Applegate, GR, et al. Recently, Cone Beam Computed Tomography (CBCT) of small joints has been introduced as an alternative technique for Multi Detector CT, combining a very high spatial resolution, low radiation dose and low cost [3]. The location of the lesion at the talus is related to the mechanism of the injury and direction of the applied force (Figure 1). Nowadays MR staging of OCL on MRI is usually done by the Anderson classification [9], which is another modification of the initial staging system based on plain film evaluation by Berndt and Harty (Figure 6). Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. AJR Am J Roentgenol. Outcomes are favorable after arthroscopic treatment of osteochondritis dissecans of the talus. Osteochondral lesions of the talus: retrograde drilling with high-field-strength MR guidance. The purpose of this study was to investigate tissue growth after arthroscopic microfracture of OLTs using computed tomography arthrography (CTA) and to identify the relationship between CTA findings and clinical outcomes. Although Conventional Radiography (CR) is still the initial diagnostic modality used for evaluation of ankle pain, later studies showed that 30–43% of talar OCL diagnosed on MRI were invisible on CR [5]. Outcomes are favorable after arthroscopic treatment of osteochondritis dissecans of the talus. The recognized sites of osteochondral defects are: Osteochondral injuries are graded according to the stability and location of the fragment and presence of secondary degenerative changes (see: osteochondral injury staging). Journal of the Belgian Society of Radiology 101 (S2): 1. Osteochondral lesion of the talus in children: Are there MRI findings of instability? Foot Ankle Surg. Electronic databases from January 1966 to December 2006 were systematically screened. Open mosaicplasty in osteochondral lesions of the talus: a prospective study. Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Epub 2009 Jun 30. This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A Clinical and Radiological 2- to 8-Year Follow-up Study. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. 1959; 41–A: 988–1020. Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): DOI: http://doi.org/10.5334/jbr-btr.1377. How the lesion condition or stage is affected by the presence of lateral instability in medial osteochondral lesions of the talus (OLT) is unclear. 16 . As such, the term encompasses a variety of pathologies, including: osteochondritis dissecans, osteochondral defects, and osteochondral fractures. Radiology. 1 ) and anterolateral (46%) talar dome ( 1 ). Pfirrmann. The first system of classification has been reported by Berndt and Harty in 1959 [4], including four stages based on their radiological appearance. Treatment depends on the location and size of the defect as well as the presence of secondary degenerative changes. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy M, Desimpel J, Vanhoenacker FM. Cartilage damage may have a variable imaging appearance ranging from a small fissure, a distinct defect, flap formation or delamination. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. The blood supply to the talus is not as rich as many other bones in the body, and as a result injuries to the talus sometimes are more difficult to heal than similar injuries in other bones. Proposed etiologic factors for the development of OCLs include trauma, ischemia, ... W.B. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, M., Desimpel, J., & Vanhoenacker, F. M. (2017). There is slight irregular delineation of the cartilage (white arrow). 1 With such an expansive categorization, OLT may occur in up to 70% of acute ankle sprains and fractures. MRI coronal PD fat suppressed image (1.5 Tesla equipment) of the talocrural joint (c) with normal appearance of the thin cartilage layer (arrows) of intermediate signal, low signal of subchondral bone and homogenous bone marrow signal (stars). Osteochondral lesions of the talus (OLT) bring the challenges both of articular cartilage healing and a constrained area of access in the ankle joint. Later on, this grading system has been modified to computed tomographic evaluation and correlated with arthroscopy, distinguishing cystic lesion of talar dome seen in primary stages with or without communication to the articular surface and detached fragment in more advanced lesions [6]. 2008; 36(9): 1750–62. 2004; 233(3): 768–73. Osteochondral lesion(s) of the talus (OLT) is an all-encompassing term for any injury involving both the subchondral bone and the articular cartilage of the talar dome, including bone bruise (contusion), osteochondritis dissecans, and osteochondral fracture. We describe ten patients with an osteochondral lesion of the talus who underwent ACI using cartilage taken from the knee and were prospectively reviewed with a mean follow-up of 23 months. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. Osteochondral lesion of talus. Medline, Google Scholar Osteochondral defects (OCD) or lesions (OCL) are focal areas of damage with articular cartilage damage and injury of the adjacent subchondral bone plate and subchondral cancellous bone. Despite the combination of these MR parameters, accurate cartilage evaluation remains often illusive. Contributed by Dr. Hemilianna Hadassa Silva Matozinho M.D. Although the majority of patients have an osteochon-dral lesion of the talus that is unilateral, bilateral involvement has been reported in 10% to 25% of cases. Drilling of osteochondral lesions of the Belgian Society of Radiology 101, no a small fissure a! Christian W.A plain film lesions and are related to trauma was in the pediatric.... 1.0–3.5 mm currently also used for diagnosing osteochondral lesions of the pathway adjustment. 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