Osteochondral Defect
What is it: An osteochondral defect is an injury to the cartilage and subchondral bone of the talar dome.
How does it present: The injury usually occurs after an ankle twisting, inversion or eversion injury. It may present acutely, but more commonly presents as chronic ankle pain that increases with activity some time after an ankle sprain.
Common exam findings: The injuries can be on the medial or lateral talar dome and the patient may have tenderness over these sites. A small joint effusion may be present and crepitus may be appreciated.
Tests and treatment: Some lesions are able to be visualized on ankle x-rays. However, if not visualized, a CT or MRI may be needed to make the diagnosis. Acute or chronic non-displaced lesions may be treated with a period of immobilization followed by rehabilitation. Recalcitrant non-displaced lesions or displaced lesions may require surgical interventions.