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Skeletal Radiology
Published in: Skeletal Radiology 4/2012

01-04-2012 | Scientific Article

High-resolution MR imaging of talar osteochondral lesions with new classification

Authors: James Francis Griffith, Domily Ting Yi Lau, David Ka Wai Yeung, Margaret Wan Nar Wong

Published in: Skeletal Radiology | Issue 4/2012

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Abstract

Purpose

Retrospective review of high-resolution MR imaging features of talar dome osteochondral lesions and development of new classification system based on these features.

Material and methods

Over the past 7 years, 70 osteochondral lesions of the talar dome from 70 patients (49 males, 21 females, mean age 42 years, range 15–62 years) underwent high-resolution MR imaging with a microscopy coil at 1.5 T. Sixty-one (87%) of 70 lesions were located on the medial central aspect and ten (13%) lesions were located on the lateral central aspect of the talar dome. Features evaluated included cartilage fracture, osteochondral junction separation, subchondral bone collapse, bone:bone separation, and marrow change. Based on these findings, a new five-part grading system was developed. Signal-to-noise characteristics of microscopy coil imaging at 1.5 T were compared to dedicated ankle coil imaging at 3 T.

Results

Microscopy coil imaging at 1.5 T yielded 20% better signal-to-noise characteristics than ankle coil imaging at 3 T. High-resolution MR revealed that osteochondral junction separation, due to focal collapse of the subchondral bone, was a common feature, being present in 28 (45%) of 61 medial central osteochondral lesions. Reparative cartilage hypertrophy and bone:bone separation in the absence of cartilage fracture were also common findings. Complete osteochondral separation was uncommon. A new five-part grading system incorporating features revealed by high-resolution MR imaging was developed.

Conclusions

High-resolution MRI reveals clinically pertinent features of talar osteochondral lesions, which should help comprehension of symptomatology and enhance clinical decision-making. These features were incorporated in a new MR-based grading system. Whenever possible, symptomatic talar osteochondral lesions should be assessed by high-resolution MR imaging.
Appendix
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Metadata
Title
High-resolution MR imaging of talar osteochondral lesions with new classification
Authors
James Francis Griffith
Domily Ting Yi Lau
David Ka Wai Yeung
Margaret Wan Nar Wong
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 4/2012
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-011-1246-8

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