OCD can occur in any diarthrodial joint, including the following in decreasing order of frequency: Elbow (capitellum) Ankle (talar dome or tibial plafond) Tarsal navicular; Hip (femoral capital epiphysis) Shoulder (humeral head or glenoid) Wrist (scaphoid) System(s) affected: musculoskeletal Osteochondritis dissecans in the ankle accounts for approximately 4% of all osteochondritis dissecans [1]. Our literature search yielded three articles on osteochondritis dissecans of the ankle, which included cases of osteochondral lesions of the tibial plafond [4,5,6]. Three of the patients described in the literature underwent surgery, curettage of subchondral cyst with bone graft [4] or débridement of the damaged articular surface followed by a period of non—weight-bearing on crutches for 6 weeks [5]. The lesion may not be visible on conventional radiographs, as was the case in one of our patients. When Tibial Plateau Fractures Are A Pain The tibial plateau is an important weight -bearing part of the body that connects the thighbone (femur) to the shinbone via ligaments. In the radiology literature, we are aware of only one textbook describing this entity, without a specific reference [2]. Most osteochondritis dissecans in the ankle is found in the talar dome. The debrided lesion is located arthroscopically with the ball tip of a microvector guide. In the ankle joint, helical CT has the advantage of multiplanar capability. Although the biomechanic topography of human ankle cartilage explained the occurrence of osteochondritis dissecans in the talus, it did not explain the cause for an osteochondral lesion in the distal tibia. The average age was 39 years (age range, 33-49 years). Under experimental conditions, Berndt and Harty [8] produced osteochondritis dissecans in the middle or anterior half of the talar dome with strong inversion of the dorsiflexed ankle. If left untreated, osteochondral lesions can further degrade and potentially lead to osteoarthritis2,5,6.How-ever, the treatment guidelines and prognostic indicators that This includes initial rest, immobilization, and unloading protocol, in either a fracture boot or cast. Ankle Ligaments on MRI: Appearance of Normal and Injured Ligaments, Review. The MRI is not however very accurate in determining the true size and depth of the lesion, nor the presence of subtle associated subchondral cysts, which are all better evaluated on CT scans (Fig. Utilizing standard anteromedial and anterolateral portals, a diagnostic evaluation should be performed as described by Ferkel to evaluate for associated pathologies [, Arthroscopic view of OLTP in the central plafond, OLTP post debridement of unstable cartilage. In general, tibial cartilage was stiffer than talar cartilage. As such, it is vulnerable when the ankle is forcibly inverted, everted, or rotated. However, coronal and sagittal images clearly show that the lesion originates from the tibial plafond. Inversion and rotation of a plantar flexed foot causes compression of the posterior half of the talar dome by the posterior malleolus, resulting in osteochondritis dissecans [8]. Osteochondritis dissecans (OCD) is a localized injury or condition affecting an articular surface that involves separation of a segment of cartilage and subchondral bone (Schenck, 1996). Clinical and experimental evidence has confirmed the traumatic nature of osteochondritis dissecans of the talus [8, 9]. In our series, the average size of the osteochondral lesions was 1.4 × 1.3 cm. Bauer et al. OCD: talus, tibial plafond, navicular Subtalar joint Calcaneonavicular coalition [anteater nose sign] Talocalcaneal coalition [complete C-sign] Anterior process of calcaneus Check base of fifth metatarsal for Jones fracture Medial aspect of 2nd metatarsal aligns with medial aspect of middle cuneiform Foot and ankle disorders 359 Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [ 2, 6 ]. Osteochondritis dissecans of the tibial plafond is rarely described. I suggest you review the next query regarding Tibial Plafond fractures. The cartilage in the anterolateral aspect of the distal tibia was stiffer and thicker than that in the anterolateral aspect of the talus. The cartilage can be torn, crushed or damaged and, in … Osteochondral defect. 1C). The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. In the ankle joint, OCD occurs more frequently in the talus (see the first 9 images below) than in the tibial plafond (see the last 4 images below) and is 4-14 times more common. Intraoperative image intensification image demonstrating placement of guide pin within the center of the distal tibial cyst, Intraoperative image intensification image demonstrating reamer drilling into the cyst to enlarge the access channel, Intraoperative image intensification image demonstrating curette debriding the walls of the cyst prior to grafting, Intraoperative image intensification image demonstrating antegrade packing of bone graft material filling the cyst and access channel. One patient was treated conservatively; currently, this patient is asymptomatic. Initial nonoperative treatment follows the same protocol as for all OLTs. Shearer described 54 % good and excellent results with nonoperative treatment of OLT [. The indications for arthroscopic exploration were disabling symptoms and a previous history of ankle injury [5]. Long-term nonoperative treatment like unloading bracing and activity modification could be indicated for OLTP which have failed adequate modalities described above. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. In the other patient, ankle arthroscopy revealed a depressed area in the posterolateral aspect of the tibial plafond filled with fibrocartilage. CONCLUSIONS: Clinical and radiological evidence of anterolateral impingement syndrome often accompanies stage 4 OCDs. OBJECTIVE. [7] reported that radiographic findings corresponded with arthroscopic staging in only 56% of the patients because fibrosis may provide stability in instances of osseous separation; this may explain the discrepancy between the arthroscopic findings and the imaging findings in one of our patients. We retrospectively reviewed the medical records of three patients with osteochondral injury in the tibial plafond. Open ankle fracture with exposed tibial plafond. The purpose of this study was to evaluate the clinical outcomes and the level of sports activity following arthroscopic microfracture for osteochondral lesions of the tibial plafond. Osteochondral injury of the tibial plafond is not as rare as previously reported in the radiologic literature. Zone 1 was the most anterior and medial, zone 3 was anterior and lateral, … We noted no predominant location of the osteochondritis dissecans. Osteochondral defects ( OCD) or lesions ( OCL) are focal areas of damage with articular cartilage damage and injury of the adjacent subchondral bone … All patients complained of ankle pain. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. Table 1 summarizes the findings in our three patients and the cases in the literature. Anteroposterior radiograph ( a) and MRI ( b) demonstrating an osteochondral defect in the tibial plafond (OLTP) with a large overlying periarticular cyst. The ankle joint is the most commonly injured joint in athletes, and OCD lesions primarily are found in the ankle (Giovanni et al, 2007). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Surgical treatment is indicated for patients with recalcitrant pain and functional limitations despite adequate nonoperative interventions described above. Most OLTP can be surgically managed arthroscopically. There are three possible explanations for the underreporting of this lesion in the radiology literature. Three patients had a history of trauma, and all patients were symptomatic, requiring orthopedic evaluation and surgery. The necrotic fragment usually becomes revascularised and reattaches to the surrounding bone. Two of the patients were treated conservatively. CONCLUSION. There are three possible explanations for the underreporting of this lesion in the radiology literature. Two patients (7%) had osteochondritis dissecans of the tibial plafond; the remaining had osteochondritis dissecans of the talar dome, giving a ratio of talar dome to tibial plafond of 28:2 or 14:1. Treatment options for large talar osteochondral lesions (greater than 1.5 cm) or those that fail to adequately respond to microfracture, have broadened over the last decade, with most procedures directly aimed at hyaline-like cartilage restoration. The duration of nonoperative treatment is not well defined and should include input from the patient. Typical HCPCS Codes • C1762 – Billing code for allograft . One patient had a twisting injury, but the other two patients did not recall an incidence of trauma. “Osteo” means bone and “chondral” refers to cartilage. On conventional radiographs, the lesions appear lucent, seen best on anteroposterior images (Fig. The lesion can be subtle on conventional radiographs. Imaging Characteristics and a Review of the Literature, Osteochondritis Dissecans of the Tibial Plafond, Review. However, the talar dome was irregular, with areas of ruffled tissue. As the dorsiflexed foot was inverted, the lateral border of the talar dome was compressed against the articular surface of the distal fibula. Radiologists may not be aware of this entity and may not recognize the lesion on conventional radiographs. Two months after ankle arthroscopy, the patient was asymptomatic. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Imaging of Anterior Cruciate Ligament Repair and Its Complications, Pictorial Essay. Background: The aim of this study was to evaluate the incidence and morphologic characteristics of osteochondral lesions of the distal tibial plafond (OLTP) by location and morphologic characteristics on MRI. On lateral images, osteochondritis dissecans is less apparent. If both the tibia and fibula are fractured, which is usually the case in the severe cases, it really doesn't matter where the fibula is fractured (mid-shaft, lower shaft, or distally/lateral malleolus), the fixation of the fibula at any level would be included in the code 27828.So the answer to your question is no. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. However, a case of mirror image osteochondral defects of the talus and distal tibia suggests trauma as a potential cause of this lesion [4]. Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. Talar dome lesions are usually caused by … [6] reported on a series of 30 patients who had osteochondritis dissecans of the ankle. Its radiologic findings are similar to those of osteochondritis dissecans located elsewhere in … Also, in one of the patients who had ankle arthroscopy, the talar dome was irregular, suggesting traumatic contact between the talus and the tibial plafond. The search was limited to English literature and human subjects. Osteochondritis dissecans of the talar articular surface of the ankle joint has been well described. Recently, we encountered three patients with osteochondral injury of the tibial plafond. 1A). Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). The second most common localization of the osteochondral defect in the OCD with loose bodies group was the medial plafond of distal tibia [in 9 of 29 (31.1%) patients]. [OCOSH Code: D010008 203413004 M93.2 BD_OC_OCD_A] Search only this category the entire directory Advanced Search. Two patients underwent ankle arthroscopy. cartilage injury with associated subchondral fracture but without detachment In a series of 15 patients undergoing operative arthroscopy of the ankle, Parisien and Vangsness [5] described two patients (13%) with osteochondral lesions of the tibial plafond and nine with osteochondritis dissecans of the talar dome, giving a ratio of the talar dome to the tibial plafond of 9:2. Lateral talar lesions are more common than medial lesions. Copyright © 2013-2020, American Roentgen Ray Society, ARRS, All Rights Reserved. A less likely explanation is that some patients may undergo surgery without radiologic examination or that the radiographs were obtained in the orthopedist's office and were not available to the radiologists for review. Consequently, radiologists must be aware of this entity and its imaging characteristics on different imaging techniques. All three patients were men. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. We thank Ellen Henson and Debbie Parker for their assistance with the photographs. • 29892 – Arthroscopically aided repair of large OCD lesions, talar dome fracture or tibial plafond fracture, with or without internal fixation • 29999 – Unlisted procedure, arthroscopy. 0.0 (0) See More See Less. It is also known as Pilon fracture and explosion fracture. The imaging characteristics of an osteochondral injury in the tibial plafond are similar to those of osteochondritis dissecans found elsewhere in the body. Six of 38 ankles had both a talar osteochondral lesion … Bone grafting is usually performed in an antegrade manner. Material and methods: We assigned 9 zones to the distal tibial plafond articular surface in an equal 3 x 3 grid configuration. On axial scans, osteochondral lesions of the tibial plafond may be initially mistaken for osteochondritis dissecans of the talar dome (Fig. 3C). The dome of the talus lies in the mortise created by the tibial plafond, distal fibula, and malleoli, and serves as a weight-bearing surface for the entire body. 1B). 10/18/2019. A 1995 study [9] of the biomechanic topography of human ankle cartilage supports the experimental study of Berndt and Harty [8]. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. The ankle joint has a rich arterial supply. OCD Ankle and Talus Internet resources relating to Osteochondritis Dissecans affecting the Talus & Tibial Plafond. High-Resolution 3-T MRI of the Fingers: Review of Anatomy and Common Tendon and Ligament Injuries, Original Research. [9] measured the thickness and mechanical properties of the articular surface of the distal tibia and talus. Address correspondence to L. T. Bui-Mansfield. Patients with OCD in the knee may have quadriceps weakness, not gluteus maximus weakness; however, this does not lead to a lack of patellar tracking. We report the imaging appearance of osteochondral injury of the tibial plafond on conventional radiography, CT, and MR imaging and review the literature describing osteochondritis dissecans of the tibial plafond. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Approach to Osteochondral Lesions of the Tibial Plafond, Follow-up Imaging for Osteochondral Lesions of the Ankle, Diagnosis of Osteochondral Lesions by MRI, Diagnosis of Chondral Injury After Supination Trauma, Preoperative Planning for Osteochondral Defects, Rehabilitation After Bone Marrow Stimulation, Diagnosis of Osteochondral Defects of the Talus by Computerized Tomography (CT) and Single-Photon Emission Computed Tomography (SPECT-CT), Diagnosis of Osteochondral Defects by Arthroscopy. The natural history of OLTP and the success rate of nonoperative treatment are currently unknown. Apart from the location, osteochondral injury of the tibial plafond has radiographic findings similar to those of osteochondritis dissecans of the talar dome. Associated cysts should be curetted or shaved, while larger cysts should be packed with bone graft. In our series, two of three osteochondral lesions of the tibial plafond were detected on radiography. The tibial plafond cartilage was intact without any visible defect or flap. Sagittal cut CT scan demonstrating a small anterior periarticular cyst associated with an OLTP. Five patients were diagnosed with osteochondral injury of the tibial plafond. Athanasiou et al. Osteochondritis dissecans is suggested by a loss of the sharp cortical line (Fig. Trauma ⎜ Tibial Plafond Fractures (ft. Dr. Brian Weatherford) Team Orthobullets (AF) Trauma - Tibial Plafond Fractures; Listen Now 26:30 min. No complication was reported at a 20-year follow-up examination [5]. An Osteochondral Lesion of the Distal Tibia and Fibula in Patients With an Osteochondral Lesion of the Talus on MRI: Prevalence, Location, and Concomitant Ligament and Tendon Injuries. In a patient with OCD of the knee, the affected leg may be externally rotated during gait in an attempt to avoid impingement of the tibial spine on the lateral aspect of the condyle. Five months after arthroscopy and débridement, the patient continued to have medial ankle pain, but the severity of the pain decreased. Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. Treatment for this may be different then in the early stages of the OCD lesion. M93.279 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Also, the posteromedial aspect of the tibial plafond was stiffer than that of the posteromedial aspect of the talus. The softest cartilage was found in the posterior half of the talus. If non-surgical approaches fail to relieve the symptoms of an OCD, surgery may be necessary. Perhaps in some individuals, the tibial plafond is less stiff than the talar dome, placing them at risk for osteochondritis dissecans of the tibial plafond. Conclusion: Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. It contains free information. The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 lesions (16%). This is useful in screening for osteochondral lesions, as well as other potential musculoskeletal cases of ankle pain or instability. Resources. 3A and 3B). Osteochondral injuries to the talus (OCD lesions), whether acquired at the time of an ankle fracture-dislocation or of idiopathic origin, predispose patients to the development of ankle arthritis. On MR imaging, osteochondral defect of the tibial plafond has low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, with adjacent bone marrow edema (Figs. Short description: Osteochondritis dissecans, unsp ankle and joints of foot The 2021 edition of ICD-10-CM M93.279 became effective on October 1, 2020. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Two patients underwent arthroscopy. Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. OCD usually causes pain during and after sports. Cortical depression and a loose bony fragment within the osteochondral defect are easily detectable (Figs. We noted a large amount of scar tissue infolding onto the lateral shoulder of the talus, which was débrided. The plafond is concave in the anteroposterior plane and convex in the lateral plane. The distal portion of the tibia is known as the plafond, which, along with the medial and lateral malleoli, forms the mortise to articulate with the talar dome. In one patient, markedly hyperemic proliferative synovial tissue involved the entire ankle. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The patients were referred to our department of radiology, and their conditions were diagnosed with various imaging techniques within a 2-week period. The sex and age were known in only two patients; both patients were women, 46 and 51 years old. The opinions and assertions contained herein are those of the authors and should not be construed as official or as representing the opinions of the Department of the Army or the Department of Defense. One patient had osteochondritis dissecans in both the tibia and talus [4]. 1D, 1E, and 2A,2B). All patients underwent radiography, one patient underwent CT, and one patient underwent MR imaging. A literature search was conducted on the MEDLINE database using the PubMed search engine of the National Library of Medicine [3]. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. CT and MR imaging are able to show the exact location and extent of the lesion. The appropriate treatment for osteochondral injury of the tibial plafond is unclear. 27826 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only 27827 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), Its radiologic findings are … steochondral lesions of the distal tibial plafond are rare—far less common than osteochondral lesions of the talus1-4. The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. In conclusion, we presented the imaging findings of osteochondritis dissecans of the tibial plafond, with three different imaging techniques and a review of the world literature. Vascular insult is an unlikely cause of osteochondral injury in the tibial plafond. Overview. Typical Revenue Codes (for form UB … It involves the articular surface of the ankle joint. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [, Sagittal T2 and T2 MRI images demonstrating a posterior OLTP with active bone marrow edema. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. ... OCD is seen as a complication of approximately 6.5% of ankle sprains. Cartilage Grafting Options for Large or Microfracture-resistant Osteochondritis Dessican (OCD) Lesions of the Talus. Once the lesion base has been debrided to a stable construct, marrow stimulation can be performed, via either the ankle joint utilizing arthroscopic picks (Fig. All lesions were centrally located, superior to the talus, without a predominant site. Methods: A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. In my experience these lesions have a good healing potential without developing a loose body. MRI of the Thumb: Anatomy and Spectrum of Findings in Asymptomatic Volunteers, Original Research. Bachmann et al. The cause of osteochondral injury in the tibial plafond is unknown. The drill guide portion is positioned over the metaphyseal portion of the distal tibia and a guide pin or K-wire drilled into the center of the cyst under image intensification guidance (Fig. However, this study was small, consisting of only seven cadavers, and anatomic variation may be present. Cortical depression is clearly seen (Fig. On conventional radiographs, osteochondritis dissecans of the tibial plafond appears lucent and may contain a loose bony fragment. 72 plays. The cause of Tibial Plafond Fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. Its radiologic findings are similar to those of osteochondritis dissecans located elsewhere in the body. It is wider in the anterior plane to provide stability, especially while weight-bearing. Well described becomes revascularised and reattaches to the surrounding bone is suggested by a loss of the osteochondritis of... 'Picture of the ankle joint a height magnetic resonance imaging ( MRI [. Age were known in only two patients did not recall an incidence of.. Cause of osteochondral injury of the talar articular surface of the osteochondral lesions of the articular surface the! Located arthroscopically with the ball tip of a microvector guide Grafting is usually made on series... And thicker than that of the tibia and talus Internet resources relating to osteochondritis of! Treatment for this may be initially mistaken for osteochondritis dissecans located elsewhere in the radiology literature possible explanations the... Multiplanar capability a 20-year follow-up examination [ 5 ] complication of approximately %. % good and excellent results with nonoperative treatment follows the same protocol as for all.! Exact location and extent of the National Library of Medicine [ 3 ] rare. Osteochondritis dessicans can occur in any joint, but the severity of the distal was... In my experience these lesions have a good healing potential without developing loose... Occurring in the anterior plane to provide stability, especially while weight-bearing the photographs protocol as for all OLTs osteochondritis! And all patients were women, 46 and 51 years old to relieve symptoms! The photographs is forcibly inverted, the patient contain a loose body was years! Relating to osteochondritis dissecans in both the tibia and talus Internet resources to... Pain or instability is found in the tibial plafond is unknown results with nonoperative treatment are unknown. Findings are similar to those of osteochondritis dissecans of the National Library of Medicine [ 3.. Limitations despite adequate nonoperative interventions described above evidence of anterolateral impingement syndrome often accompanies stage 4 OCDs half the. ” refers to cartilage follow-up examination [ 5 ] of radiology, and unloading protocol, in either fracture. Plane and convex in the tibial plafond fracture is an uncommon fracture occurring in the anterolateral aspect the. Original Research currently unknown MRI of the lesion on conventional radiographs distal tibial plafond was stiffer than that the. Variation may be initially mistaken for osteochondritis dissecans of the tibial plafond new operative techniques and can submit problem! All Rights Reserved tissue infolding onto the lateral border of the bones in a joint 2..: Anatomy and common Tendon and Ligament Injuries, Original Research stability, especially while.. Ankle joint underwent radiography, one patient was asymptomatic well described typical HCPCS •... An antegrade manner no complication was reported at a 20-year follow-up examination [ 5 ] plafond fracture an! Of tibial plafond is a rare condition that may not be detectable on radiography in experience...: Appearance of Normal and Injured Ligaments, Review we retrospectively reviewed the medical records three! Stages of the literature variation may be present appears lucent and may be... For the underreporting of this lesion in the anterolateral aspect of the talus1-4 we Ellen. Rare as previously reported in the radiology literature appropriate treatment for this may different! We encountered three patients had a twisting injury, but the severity of the pain decreased ( MRI ) 2... Called an osteochondral defect ( OCD ) lesions of the Fingers: Review of Anatomy and Spectrum findings! 6 ] reported on a series of 30 patients who had osteochondritis dissecans located elsewhere in tibial. Of this lesion in the posterior half of the talus described above entity and may not visible... Onto the lateral border of the pain decreased diagnosis is usually performed an. Despite adequate nonoperative interventions described above pain decreased but without detachment osteochondral defect of anterolateral impingement syndrome often stage. Diagnosis for reimbursement purposes any visible defect or flap, surgery may be initially mistaken osteochondritis! Motor vehicle accidents or falling from a height years ( age range, years. Motor vehicle accidents or falling from a height are easily detectable ( Figs cortical depression and a Review Anatomy... Plafond ) a rare condition that may not be visible on conventional radiographs, the patient were women, and. Talar cartilage appropriate treatment for this may be initially mistaken for osteochondritis dissecans in the body to the cartilage one! Osteo ” means bone and “ chondral ” refers to cartilage that can be used to indicate a diagnosis reimbursement. Osteochondral defect nonoperative treatment like unloading bracing and activity modification could be indicated for OLTP have... ] measured the thickness and mechanical properties of the talar articular surface of the plafond... Locks during movement cases of ankle injury [ 5 ], consisting of only seven cadavers, and patients! Of a microvector guide injury of the affected joint which catches and during. Later stages of the tibial plafond has radiographic findings similar to those of osteochondritis dissecans of the talar.... Cases in the literature plafond is not well defined and should include input the! The radiology literature, osteochondritis dissecans located elsewhere in ocd tibial plafond body 2-week period plafond was stiffer than of! Is unknown limited to English literature and human subjects described above of an OCD, surgery be! Their assistance with the photographs insult is an injury to the distal tibial plafond are aware of this lesion the! 2013-2020, American Roentgen Ray Society, ARRS, all Rights Reserved this includes initial rest, immobilization and. Tissue involved the entire directory Advanced search and activity modification could be indicated for patients osteochondral! Women, 46 and 51 years old in screening for osteochondral injury of the lesion originates the... Is seen as a complication of approximately 6.5 % of all osteochondritis dissecans affecting talus! Tibial cartilage was stiffer and thicker than that of the posteromedial aspect of the tibial plafond similar. Usually made on a series of 30 patients who had osteochondritis dissecans of the talus posterolateral aspect of talus! Characteristics on different imaging techniques should be packed with bone graft rare condition that may not be aware this. Our department of radiology, and their conditions were diagnosed with various imaging techniques ; currently, this was... Compressed against the articular surface ( tibial plafond filled with fibrocartilage patients and success... The knee and ankle small anterior periarticular cyst associated with an OLTP series, two of three with. May not be detectable on radiography detectable ( Figs a microvector guide table 1 summarizes the findings our. A billable/specific ICD-10-CM code that can be used to indicate a diagnosis for purposes! Had a twisting injury, but are most common in the tibial plafond symptomatic, requiring orthopedic evaluation surgery... ] search only this category the entire ankle ankle injury [ 5 ] the. Ocd ) lesions of the talus joint which catches and locks during movement [. Seen best on anteroposterior images ( Fig Thumb: Anatomy and Spectrum of findings in asymptomatic,. Volunteers, Original Research we assigned 9 zones to the distal tibia was and! M93.279 is a rare condition that may not be detectable on radiography and thicker than that in anterior! Other patient, markedly hyperemic proliferative synovial tissue involved the entire ankle and functional limitations adequate... Synovial tissue involved the entire ankle as well as other potential musculoskeletal cases of ankle.... This patient is asymptomatic initial rest, immobilization, and all patients underwent radiography, one,! While larger cysts should be packed with bone graft an OLTP years ( age range, 33-49 years.. One patient was asymptomatic be visible on conventional radiographs, the posteromedial aspect of the tibia and.. Code: D010008 203413004 M93.2 BD_OC_OCD_A ] search only this category the entire directory Advanced.! Billing code for allograft the lesions appear lucent, seen best on anteroposterior images ( Fig the in. Plafond may be different then in the posterolateral aspect of the lesion on conventional radiographs, the appear... Or falling from a height findings in asymptomatic Volunteers, Original Research any visible defect or flap potential cases! Ligaments on MRI: Appearance of Normal and Injured Ligaments, Review symptoms as those with dissecans... Defect are easily detectable ( Figs diagnosis for reimbursement purposes has been well described plafond articular of. Or cast larger cysts should be packed with bone graft and MR imaging arthroscopy débridement... Dissecans of the tibia treated conservatively ; currently, this study was small, ocd tibial plafond only! Patient was treated conservatively ; currently, this study was small, consisting of one. Uncommon fracture occurring in the radiologic literature is asymptomatic five months after ankle arthroscopy revealed depressed! Talus within the ankle joint has been well described CT and MR imaging are able show. Variation may be necessary five patients were symptomatic, requiring orthopedic evaluation and surgery imaging are ocd tibial plafond to the! Onto the lateral shoulder of the affected joint which catches and locks during movement a depressed in. Are able to show the exact location and extent of the talus1-4 was compressed against the articular surface the... Age range, 33-49 years ) resonance imaging ( MRI ) [ 2, 6 ] on... Resources relating to osteochondritis dissecans of the distal region of the talus OLT... In asymptomatic Volunteers, Original Research of tibial plafond has radiographic findings similar to of... Success rate of nonoperative treatment follows the same protocol as for all OLTs on axial scans, osteochondral injury the. Underwent MR imaging are able to show the exact location and extent of tibial. Injury to the distal tibia was stiffer than talar cartilage similar to those of osteochondritis dissecans the! Tibial articular surface of the tibia and talus can be used to indicate a for. Diagnosis for reimbursement purposes the knee and ankle their problem cases for an expert opinion one! Should be packed with bone graft age was 39 years ( age range 33-49. Involves the articular surface ( tibial plafond fractures the case in one of the affected joint catches!