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Osteochondral Injuries of the Ankle
Osteochondral injuries are one of the most common causes of ankle pain. Though in a majority of cases there is a history of injury or trauma, some cases may not have any previous history of ankle injury. A condition known as osteochondritis dissecans is characterized by damage and separation of a piece of bone and cartilage within the joint,from the underlying bone. In the ankle joint it mainly affects the talus bone.
Causes: The natural causes of osteochondral injuries are still not clear.. Sometimes an ankle sprain may also result in an osteochondral injury.
Symptoms: The predominant symptom of an osteochondral injury is pain, which may be localized to the ankle joint. Other symptoms include tenderness and swelling of the ankle joint with difficulty in weight bearing. Some patients complain of locking of the ankle. In most of the patients it may also be associated with ligament injuries.
Diagnosis: Osteochondral injuries can be diagnosed by physical examination, X-ray and other advanced imaging techniques such as CT and MRI scan. A CT scan helps identify any bony fragments and cysts, but is not very helpful to visualize bone edema or cartilage defects. MRI is the best imaging modality to visualize the cartilage and the bone lesions as well as bone edema.
Treatment: Both non-surgical and surgical treatments can be used for the management of osteochondral injuries of the ankle joint. Surgical treatment is recommended for more severe injuries and involves the debridement of the flaps of cartilage and removal of any loose bodies.
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