🔴Radiographic classification of osteochondral lesions of talus

I: a small area of subchondral compression
II: partial fragment detachment
III: complete fragment detachment but not displaced
IV: displaced fragment

Here you see 3 cases of osteochondritis dissecans(arrowheads).

Osteochondral Lesions of the Knee

pubs.rsna.org/doi/abs/10.114…

Beautiful review on Osteochondral Lesions of the Knee & Differentiating the Most Common Entities at MRI #radres #mskrad #FOAMrad #FOAMed #MedTwitter

pubs.rsna.org/doi/full/10.11…

Osteochondral Lesions of the Knee

pubs.rsna.org/doi/abs/10.114…

1/ posterior ankle pain, instability in a 26 y/o semi-pro placekicker. Findings of posterolateral impingement are shown:
-thickened intermalleolar/PTF ligaments
-posterior subtalar synovitis
-degenerative osteochondral lesion posterolateral talus

Natural history of an unstable osteochondral lesion of the knee over a 10 month period

Osteochondral lesions of Talus:
MRI classification of Anderson widely used, which is modification of initial staging based on plain film. MRI is very useful,but lack of spatial resolution hampers accurate assessment.. So CBCT arthrography is very precise.
doi.org/10.5334/jbr-bt…

Nice MRI-radiographic correlation: osteochondral lesion of the talus
journals.sagepub.com/doi/abs/10.117…

Autologous osteochondral transplantation (mosaicplasty) for the replacement of an osteochondral lesion of the talus. Indicated for defects between 1-4 cm2. Depending on the location, it may require a tibial osteotomy for accessing the OCL

MR arthrogram of the shoulder for post-traumatic assessment. No rotator cuff injury but oblique osteochondral glenoid fracture with bone marrow edema and slight anterior cortical displacement. #MSKrad #orthopaedics #shoulder

Fx(s)of Articular Surfaces:
●Subchondral
●Chondral
●Osteochondral Fx(s)
In Subchondral injury,articular cartilage is intact& joint surface not depressed.

Chondral Fx may be associated with a cartilage defect

In Osteochondral Fx:damage to articular cartilage&subchondral bone

🦴⚽Talus Osteochondral Bruises and Defects: Diagnosis and Differentiation

sciencedirect.com/science/articl…

Lateral pat dislocation

How MRI helps:
1. MPFL-Complete MPFL disruption here
2. Extent of patellar/lat fem condyle injury and importantly loose osteochondral fragment identification as here
3. Background PF joint-dysplasia here
4. Sometimes clinically confused with ACL injury

Uncommonly, osteochondral bodies can migrate here and then grow large/fat like this. By the way, who was Henry? (Henry's Knot). Foot and ankle surgeon?

A favorite operation for #orthotwitter :
Osteochondral allograft transplantation

9mo after bipolar patellofemoral fresh osteochondral allograft transplantation 👇👇👇👇

Full thickness osteochondral lesion in a 60/M with an open transverse patella fracture. He fell from a step ladder and landed on his left knee. #orthotwitter

✅Among all the fresh osteochondral allografts of the knee, those involving contained isolated injuries of the medial femoral condyle in a normal-aligned knee show the more predictable and superior clinical outcomes ✅

Intra-articular, mass-forming cartilaginous lesions:

#Osteochondral loose bodies (note concentric ring architecture) vs. synovial chondromatosis (more uniform, cellular hyaline #cartilage ; is #neoplastic , with FN1 and/or ACVR2A fusions).

#PathTwitter #BSTPath

A bone ‘bruise’ or contusion can occur due to impact / trauma, causing deep persistent pain for several months- here, lateral tibial plateau in healthy young female

There doesn’t have to be a subchondral insufficiency fracture (SIF), osteochondral injury etc