Advertisement

MR arthrographic evaluation of the association between anterolateral soft tissue impingement and osteochondral lesion of the tibiotalar joint

  • Hayri OgulEmail author
  • Onur Taydas
  • Kutsi Tuncer
  • Gokhan Polat
  • Berhan Pirimoglu
  • Mecit Kantarci
MUSCULOSKELETAL RADIOLOGY
  • 5 Downloads

Abstract

Purpose

To retrospectively evaluate on magnetic resonance (MR) arthrography the relationship between joint capsule thickness and the stage of osteochondral lesions of the tibiotalar joint, as well as to evaluate the ankle joint capacity in patients with osteochondritis dissecans (OCD). Also, we demonstrate the unusual locations of osteochondral lesions of the ankle joint.

Methods

MR arthrography images were analyzed by two staff radiologists in consensus. The normality of the data was analyzed by the Kolmogorov–Smirnov test. The Mann–Whitney U test was used to compare the relationship between joint capsule thickness and patient groups with OCD.

Results

The anterolateral joint capsule thickness was significantly higher than the anteromedial and posterior joint capsule thickness in the OCD with loose bodies group (p = 0.049). Osteochondral defects were most commonly detected at the medial talar dome: in 29 of 37 patients (78.3%) in the OCD without loose bodies group and in 16 of 29 (55.2%) patients in the OCD with loose bodies group. The second most common localization of the osteochondral defect in the OCD with loose bodies group was the medial plafond of distal tibia [in 9 of 29 (31.1%) patients].

Conclusions

Clinical and radiological evidence of anterolateral impingement syndrome often accompanies stage 4 OCDs. OCDs of the distal tibial plafond are not rare in the ankle joint and are often associated with loose bodies.

Keywords

Ankle joint MR arthrography Anterolateral impingement Osteochondritis dissecans Loose body 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Berndt AL, Harty M (1959) Transchondral fractures (Osteochondritis Dissecans) of the talus. J Bone Joint Surg Am 41-A:988–1020CrossRefGoogle Scholar
  2. 2.
    Flick AB, Gould N (1985) Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. Foot Ankle 5(4):165–185CrossRefGoogle Scholar
  3. 3.
    Stone JW (1996) Osteochondral lesions of the talar dome. J Am Acad Orthop Surg 4(2):63–73CrossRefGoogle Scholar
  4. 4.
    Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC (2009) Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. Foot Ankle Int 30(6):524–529CrossRefGoogle Scholar
  5. 5.
    You JY, Lee GY, Lee JW, Lee E, Kang HS (2016) 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. AJR Am J Roentgenol 206(2):366–372CrossRefGoogle Scholar
  6. 6.
    Mologne TS, Ferkel RD (2007) Arthroscopic treatment of osteochondral lesions of the distal tibia. Foot Ankle Int 28(8):865–872CrossRefGoogle Scholar
  7. 7.
    Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC (2012) Arthroscopic treatment of osteochondral lesions of the tibial plafond. Foot Ankle Int 33(8):662–668CrossRefGoogle Scholar
  8. 8.
    Bui-Mansfield LT, Kline M, Chew FS, Rogers LF, Lenchik L (2000) Osteochondritis dissecans of the tibial plafond: imaging characteristics and a review of the literature. AJR Am J Roentgenol 175(5):1305–1308CrossRefGoogle Scholar
  9. 9.
    Robinson P, White LM, Salonen DC, Daniels TR, Ogilvie-Harris D (2001) Anterolateral ankle impingement: MR arthrographic assessment of the anterolateral recess. Radiology 221(1):186–190CrossRefGoogle Scholar
  10. 10.
    Cerezal L, Abascal F, García-Valtuille R, Canga A (2005) Ankle MR arthrography: how, why, when. Radiol Clin N Am 43(4):693–707CrossRefGoogle Scholar
  11. 11.
    Ogul H, Guzel Y, Pirimoglu B, Tuncer K, Polat G, Ergun F et al (2016) The clinical and radiological importance of extraarticular contrast material leakage into adjacent synovial compartments on ankle MR arthrography in patients with OCD and anterolateral impingement. Eur J Radiol 85(10):1857–1866CrossRefGoogle Scholar
  12. 12.
    Badekas T, Takvorian M, Souras N (2013) Treatment principles for osteochondral lesions in foot and ankle. Int Orthop 37(9):1697–1706CrossRefGoogle Scholar
  13. 13.
    Zanon G, DI Vico G, Marullo M (2014) Osteochondritis dissecans of the talus. Joints 2(3):115–123CrossRefGoogle Scholar
  14. 14.
    Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME, Raikin SM (2007) Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int 28(2):154–161CrossRefGoogle Scholar
  15. 15.
    McCarthy CL, Wilson DJ, Coltman TP (2008) Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging. Skelet Radiol 37(3):209–216CrossRefGoogle Scholar
  16. 16.
    Athanasiou KA, Niederauer GG, Schenck RC Jr (1995) Biomechanical topography of human ankle cartilage. Ann Biomed Eng 23(5):697–704CrossRefGoogle Scholar
  17. 17.
    Elentuck D, Palmer WE (2004) Direct magnetic resonance arthrography. Eur Radiol 14(11):1956–1967CrossRefGoogle Scholar
  18. 18.
    Bohndorf K (1999) Imaging of acute injuries of the articular surfaces (chondral, osteochondral and subchondral fractures). Skelet Radiol 28(10):545–560CrossRefGoogle Scholar

Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  1. 1.Department of Radiology, Medical FacultyAtaturk UniversityErzurumTurkey
  2. 2.Department of RadiologyErzincan University Mengücek Gazi Training and Research HospitalErzincanTurkey
  3. 3.Department of Orthopedic, Medical FacultyAtaturk UniversityErzurumTurkey
  4. 4.Üniversite Mah.Yakutiye/ErzurumTurkey

Personalised recommendations