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
