The accuracy also depends of the strength of the field and is lower on 1.5 Tesla magnets in comparison to 3T [11]. High-grade fluid-filled lesions with cortical collapse and severe osteoarthritis might require arthroplasty. 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). 3. 2008; 16(11): 1047–51. 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). Subchondral cysts of the tibia secondary to osteoarthritis of the knee. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. The overlying cartilage is intact at the talus, whereas there is subtle cartilage lesion at the distal tibia (arrow). Polesello G, Sakai DS, Ono NK, et al. Sagittal PD fat suppressed MRI image (a) showing BME (star) at the posteromedial part of the talar dome. 195 (1): W63-8. It uses a conical X-ray beam and flat-panel detector collecting all volumetric data in one rotation of the gantry. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. DOI: https://doi.org/10.2106/00004623-195941060-00002, Hepple, S, Winson, IG and Glew, D. Osteochondral lesions of the talus: A revised classification. DOI: https://doi.org/10.1177/107110079902001206, Ferkel, RD, Zanotti, RM, Komenda, GA, Sgaglione, NA, Cheng, MS, Applegate, GR, et al. Subchondral insufficiency fractures are more common in elderly women 1,4,6. Some authors suggest that … The overlying cartilage is difficult to assess on MRI but seems to be slightly inhomogeneous (white arrow). The area between the fracture line and the articular surface should be of high signal in T2 weighted images 2,4. Arthroscopic treatment of chronic osteochondral lesions of the talus: Long-term results. (2009) Osteoarthritis and cartilage. At earlier stages (stage 1 to 4), a number of options exist including: Cartilage thickness in cadaveric ankles: Measurement with double-contrast multi-detector row CT arthrography versus MR imaging. The synovial fluid intrusion theory suggests that elevated intra-articular pressure forces joint fluid into the subchondral bone via fissured or ulcerated cartilage,, creating a cyst. Subchondral bone cysts (SBCs) are sacs filled with fluid that form inside of joints such as knees, hips, and shoulders. A comparison of arthroscopic and MRI findings in staging of osteochondral lesions of the talus. Coronal (c) and sagittal (d) reformatted CBCT-A show a focal bony lesion with peripheral sclerosis in the distal tibia and talus. Subchondral cysts and intraosseous ganglion cysts cannot be differentiated histologically. 1. Diagnostic value of CT arthrography for evaluation of osteochondral lesions at the ankle. Foot Ankle Int. Jose J, Pasquotti G, Smith MK, et al. Sclerotic lines as a result of impaction or as slight deformities of the joint line in case of subchondral collapse can sometimes be seen particularly at a later stage 4. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy M, Desimpel J, Vanhoenacker FM. A subchondral cyst (Fig. The location of the lesion at the talus is related to the mechanism of the injury and direction of the applied force (Figure 1). Articular cartilage lining remains homogenous without any signal changes (Figure 7). The index cases demonstrate a subchondral fracture, which progresses to osteonecrosis and cortical collapse. In the region of subchondral edema, in osteoarthritis the most common pathological changes are necrosis, fibrosis, and trabecular abnormalities . 6. Stage 2 refers to partial detachment of OCL with subchondral cyst formation or fissure incompletely separating the lesion from the talar dome. Coronal PD fat suppressed coronal image (a) showing an OCL fragment completely detached from talar dome without displacement (arrow), bone marrow oedema (star) of adjacent part of the talus. 468 (12): 3181-5. 101, no. This article highlights some of the causes and treatment options for Subchondral Bone Cysts. 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]. 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