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Computed tomography arthrography versus magnetic resonance imaging for diagnosis of osteochondral lesions of the talus

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Osteochondral lesions of the talus (OLT) usually have non-specific clinical symptoms, and radiographs have a low sensitivity for detecting OLT. The purpose of this study is to compare the diagnostic value of CT arthrography (CTa) with that of MRI using arthroscopy as the reference standard for grading OLT.

Materials and methods

We retrospectively reviewed patients who had OLT between 2015 and 2020. Patients with symptomatic OLT as a surgical indication, who were treated arthroscopically, and underwent both CTa and MRI before surgery were included. OLT was evaluated by both CTa and MRI using arthroscopy as the standard. We graded CTa, MRI, arthroscopic findings using Mintz classification.

Results

Thirty-five patients were included. Accuracy rates of MRI and CTa for grading OLT, compared to those of arthroscopy, were 57.1% and 88.6%, respectively. Among 15 mismatched cases in MRI, 12 lesions (80%) were matched in CTa and arthroscopy. CTa had significantly higher diagnostic performance than MRI for the detection of grade III lesions (p = 0.041). Using the receiver operating characteristics curves, the area under the curve values for lesion grading were 0.893 for CTa and 0.762 for MRI.

Conclusion

CTa was statistically significantly better in detecting chondral flapping or subchondral exposure lesions for OLT than MRI on using arthroscopy as the reference standard. Because the stability of the OLT is essential in determining the treatment method, if an OLT is observed on MRI and is suspected to cause ankle pain, we recommend additional CTa examination to determine the more correct treatment strategies for OLT.

Level of evidence

Diagnostic Level III.

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Data availability

The dataset generated shall be available upon reasonable request to the corresponding author.

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Funding

This study was supported by a grant (NRF-2017M3A9E2063104) from the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science & ICT, Republic of Korea. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea

    Dae-Yoo Kim & Jun-Min Yoon

  2. Department of Orthopedic Surgery, SNU Seoul Hospital, Seoul, Republic of Korea

    Gil Young Park & Dong-Oh Lee

  3. Department of Orthopedic Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea

    Ho Won Kang

  4. College of Medicine, Seoul National University, Seoul, Republic of Korea

    Dong Yeon Lee

  5. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea

    Dong Yeon Lee

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  1. Dae-Yoo Kim
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Correspondence to Dong Yeon Lee.

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Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members.

Ethical review committee statement

Ethical approval for this study was obtained from Seoul National University Hospital, Seoul, Republic of Korea (approval number H-1806–035-949).

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Kim, DY., Yoon, JM., Park, G.Y. et al. Computed tomography arthrography versus magnetic resonance imaging for diagnosis of osteochondral lesions of the talus. Arch Orthop Trauma Surg 143, 5631–5639 (2023). https://doi.org/10.1007/s00402-023-04871-5

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  • DOI: https://doi.org/10.1007/s00402-023-04871-5

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