Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities  

作　　者：Christiaan JA van Bergen Rogier M Gerards Kim TM Opdam Maaike P Terra Gino MMJ Kerkhoffs 

机构地区：[1]Department of Orthopedic Surgery,Academic Medical Center [2]Department of Radiology,Academic Medical Center

出　　处：《World Journal of Orthopedics》2015年第11期944-953,共10页世界骨科杂志（英文版）

摘　　要：This current concepts review outlines the role of diffe-rent imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone(usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography(CT) and magnetic resonance imaging(MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.This current concepts review outlines the role of diffe-rent imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone(usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography(CT) and magnetic resonance imaging(MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.

关 键 词：CARTILAGE Subchondral bone IMAGING ANKLE TALUS RADIOGRAPHY Computed tomography Magnetic resonance IMAGING Outcome assessment 

分 类 号：R684[医药卫生—骨科学]