Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.944
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
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.
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.