Minireviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2015; 6(11): 944-953
Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.944
Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities
Christiaan JA van Bergen, Rogier M Gerards, Kim TM Opdam, Maaike P Terra, Gino MMJ Kerkhoffs
Christiaan JA van Bergen, Rogier M Gerards, Kim TM Opdam, Gino MMJ Kerkhoffs, Department of Orthopedic Surgery, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
Maaike P Terra, Department of Radiology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
Author contributions: van Bergen CJA drafted, coordinated and finalised the paper; Gerards RM specifically contributed to the conclusions, future directions and figures; Opdam KTM contributed to the references and figures; Terra MP contributed to postoperative MRI; Kerkhoffs GMMJ supervised the writing process; all authors reviewed the paper and approved the final version.
Conflict-of-interest statement: The authors declare that they do not have a conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Christiaan JA van Bergen, MD, PhD, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. c.j.vanbergen@amc.nl
Telephone: +31-20-5669111 Fax: +31-20-5669117
Received: May 28, 2015
Peer-review started: June 1, 2015
First decision: August 4, 2015
Revised: September 2, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: December 18, 2015
Abstract

This current concepts review outlines the role of different 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.

Keywords: Cartilage, Subchondral bone, Imaging, Ankle, Talus, Radiography, Computed tomography, Magnetic resonance imaging, Outcome assessment

Core tip: This current concepts review aims to summarize the literature on imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. There have been recent developments in this field, including the use of sophisticated methods for diagnosis [such as single photon emission computed tomography (CT)] and the use of imaging for outcome assessment (such as CT and certain magnetic resonance imaging techniques). These are all discussed in the article, which may help the reader to optimize his/her preoperative and postoperative strategy.