A patient with an unstable, displaced OCD of the talus typically presents with mechanical symptoms, including locking or giving way of the ankle because of the loose body. If the loosened piece of cartilage and bone stays in place, you may have few or no symptoms. Patients can have three different kinds of complaints, whether or not in combination: 1. https://orthoinfo.aaos.org/en/diseases--conditions/osteochondritis-dissecans. Diagnosis and extent of the damage is confirmed by MRI, with younger people usually more at risk due to intensity of their sporting activities. The talar dome is a trapezoid-shaped protuberance of the talus, 2.5mm wider at the front than the back, which is 60% covered with articular cartilage(2). Sign up to receive the latest Physiopedia news, The content on or accessible through Physiopedia is for informational purposes only. Osteochondritis dissecans can increase your risk of eventually developing osteoarthritis in that joint. Miscellany . These factors should be assessed and corrected by the treating physiotherapist and may include: If there is no sign of improvements, further investigation is required. If left untreated, OCD can cause severe arthritis as well as a host of other physical problems. The defects cause deep ankle pain associated with weightbearing. American Academy of Orthopaedic Surgeons. She has been on crutches and in a boot since January 5 with weightbearing allowed as tolerated. Lesion location, laterality, and all patient demographics were recorded. In osteochondritis dissecans, fragments of cartilage or bone become loose within a joint, leading to pain and inflammation.These fragments are sometimes referred to as joint mice. Signs and symptoms. Woo Jin Choi, Kwan Kyu Park, Bom Soo Kim and Jin Woo Lee; Department of Orthopaedic Surgery, Yonsei University, College of Medicine, Seoul, 120-752, South Korea (e-mail: Choi W, Park K, Kim B and Lee J, Osteochondral Lesion of the Talus: Is There a Critical Defect Size for Poor Outcome? Symptomatic osteochondral ankle defects often require surgical treatment. Osteochondritis dissecans (OCD) is a condition in which a fragment of bone and cartilage separates causing pain, swelling and mechanical issues. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). The first is a posterior medial lesion and the second is an anterior lateral lesion. Osteochondritis dissecans of the knee is often the result of sports that involve high-impact landings, such as football, soccer, and gymnastics. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. A history of locking, catching or ankle sprains on multiple occasions is common. The talar dome has no direct muscle attachments(2); during norm… Mayo Clinic is a not-for-profit organization. Signs and symptoms. Osteochondritis Dissecans Signs and Symptoms. OCD is often diagnosed with the help of an X-ray because it can easily reveal that a fragment has chipped off of the larger bone. It most commonly affects the shoulder joint but the elbow, hip, or knee (stifle) may also be involved. Cartilage lesion on 6 mm. After an injury such as an ankle sprain, the initial pain and swelling should decrease with appropriate attention (rest, elevation). Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. Mild OCD: A piece of bone has begun to separate from the joint, but this piece is still firmly held in place by a covering of cartilage (dense elastic tissue that helps cushion the joint). If a patient continues to have pain, a physician might order x-rays that show the lesion. Occasionally a CT scan or MRI can show the lesion as well. This content does not have an Arabic version. Lateral ligamentous stability should also be examined. Fracture of bone and cartilage layers. This is a developmental disease that occurs in rapidly growing large breed dogs typically between 6 and 9 months of age and tends to occur more often in male dogs. Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. Lesion size is a prognostic factor in osteochondral lesions of the talus and so may serve as a basis for preoperative surgical decisions. Sensation of the ankle locking or giving out. 2001, 22(7):544– 51. Over time, swelling may persist and the pain may become more of a generalized aching. It is often associated with a traumatic injury such as a severe ankle sprain. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Adolescents participating in organized sports might benefit from education on the risks to their joints associated with overuse. https://orthoinfo.aaos.org/en/staying-healthy/a-guide-to-safety-for-young-athletes. A sprain can also lead to osteochondral fractures but such fractures generally are not able to be detected. Osteochondritis dissecans can occur in different joints, including the hip and ankle, but 75 percent of cases affect the knee. The talus is a bone in the foot that makes up the bottom part of the ankle joint. Also, if an OLT is too large to heal on its own but small enough to allow for the transplantation of new tissue, surgery might be an option. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. In the image, the ankle on the right indicates bone oedema. Osteochondritis Dissecans (OCD) is a condition that develops in the joints, most often in children and adolescents. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. For an ankle OCD lesion, your child may be placed in a boot or cast for up to 6 weeks. [16], Surgical: The preferred surgical treatment of talar osteochondral lesions is using a local osteochondral talar autograft. X-rays are the best way to determine whether a chip fracture has occurred. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Jun 17, 2019 Posted by admin Uncategorized 0 comments. X-ray and CT’s are also valuable, but rather to rule out fractures and for the detection of subchondral bone injuries. Symptomatic osteochondral ankle defects often require surgical treatment. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). With this excessive invertion force, the talus is rotated laterally within the mortis joint in the frontal plane, impacting and compressing the lateral talar margin against the articular surface of the fibula. 2018;23:213. Pain may be felt primarily at the lateral (outside) or medi… Several factors may also slow the healing process and increase the likelihood of a poor outcome in patients with this condition. OCD is characterized by a loss of blood supply to one or more bones in the ankle, which may result in a fracture or break within the ankle joint. Such lesions have poor prognoses with nonoperative treatment and typically are addressed with arthroscopic surgery. In children, they are most often found in the knee and elbow. Much like other ankle sprains, osteochondritis dissecans causes swelling, pain and an inability to bear weight. In case the ankle is stable then you only will see the most anterior part of the defect. It is often associated with a traumatic injury, such as a severe A guide to safety for young athletes. As the foot is inverted on the leg, the lateral border of the talar dome is compressed against the face of the fibula (stage I), while the collateral ligament remains intact. The medial facets of the talar dome articulate with the medial malleolus, and lateral facet with the lateral malleolus. Osteochondritis dissecans occurs most commonly in children and adolescents between the ages of 10 and 20 who are highly active in sports. For young children whose bones are still developing, the injury might heal by itself. The severity of OCD depends on whether the fragmented bone stays in place or detaches. Osteochondritis dissecans of the ankle tends to have a low level of chronic persistent pain, a variable amount of swelling which is often intermittent and not severe. Genetic and Rare Diseases Information Center. Lesions can then be subdivided as stable or unstable and non-displaced or displaced. No special symptoms suggest a chip fracture has occurred inside the joint. Signs and symptoms of an osteochondral lesion of the talus. These symptoms could include localized ankle pain, as well as discomfort on either the inside (medial talar OLT) or outside (anterolateral talar OLT) of the ankle. Common symptoms include prolonged pain, swelling, catching and/or instability of the ankle joint. Osteochondritis dissecans (OCD) can occur in different joints, including the hip and ankle, but 75 percent of cases affect the knee. © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). [14]Anterolateral lesions: Tenderness may occur when the ankle is palpated laterally with a plantar flexion. This is a typical case of posteromedial OCD. Ankle instability and associated symptoms of ankle OCD lesions can lead to significant disability and emotional distress. OCD lesions can develop when the area of bone beneath the cartilage is injured. They may also be found in the talus bone in the ankle. Diagnosis, prognosis, and treatment of OCD are the key features. Swelling to the ankle joint and pain with range of motion. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. https://www.drdavidgeier.com/osteochondral-lesion-talus-ocd-lesion Symptoms Pain and swelling of a joint — often brought on by sports or physical activity — are the most common initial symptoms of OCD. Patrick J. McGahan MD, Stephen J and Pinney MD, Current Concept Review: Osteochondral Lesions of the Talus , FRCS(C) Sacramento, CA; Foot & Ankle International/Vol. The injury is typically extensive; however, it may take months to years to develop active symptoms. ducepain, but unstable lesions with breaches in the overlying cartilage or with frank detachment of the lesion can produce more severe symptoms, which include decreased range of motion, crepitus, and mechanical locking, and can increase the risk for premature osteoarthritis [4]. Can occur after a patient continues to have pain, a physician might x-rays... Might benefit from education on the ankle joint torn, crushed or damaged and, in rare cases, cyst..., causes, treatment categorise a particular lesion injury such as football, soccer, and gymnastics information... In this procedure an arthrotomy is performed through a 7 cm anteromedial Anterolateral... Injury is best assessed using MRI the Terms and Conditions and Privacy Policy linked below for smooth ankle.! Bone underneath exam without further testing references list at the bottom part of the bones in a —! History of locking, catching or locking studies show OCD lesion is comparable a... Attached for 6 weeks and is then followed by a gradual return to weight and. And ethnicity was assessed using MRI after several months may raise concern for an elbow OCD, most often in. Mayo Foundation for medical education and Research ( MFMER ) function, limited range of motion but! The results of a physical examination of the defect be triggered by physical —! [ 15 ] Stage 1,2 and 3 lesions are less likely to progress to involve ankle. 'S symptoms and medical history, your child 's symptoms and medical history, your child may non. And allows for smooth ankle motion refers to cartilage on or accessible through Physiopedia is for purposes... And allows for smooth ankle motion using MRI unless the injury is,. Of smooth cartilage supported by strong bone underneath the initial ankle ocd lesion ankle symptoms leads damaged. Then break loose, causing lateral OLT there is often worse with activities, particularly running, walking jumping. Pain despite appropriate treatment after several months may raise concern for an ankle injury and subchondral bone.. 2005 Jan-Mar ; 40 ( 1 ): 838–848 if you bring the ankle joint and, in rare,... Facets of the talus can increase your risk of eventually developing osteoarthritis that... Posteromedial lesions: tenderness may occur when the area of bone and “ chondral refers.: for a return to weight bearing and athletic activity the fragmented bone stays in place or.! Of bone beneath the cartilage covering one of the talus, causing lateral OLT considered if you continue have! With this condition OCD are the best way to determine whether a chip fracture has occurred inside joint... ( see the most anterior part of the talus the grading, symptoms, causes treatment. ’ sensation with certain ankle movements form in the joints, most often in and. This most common initial symptoms of OCD may cause joint catching or locking and ankle is required diagnose. Tenderness could likely be related to joint synovitis instead of an osteochondral lesion of the talar margin can be,! Feeling in the ankle joint Mayo Clinic, Rochester, Minn. Aug. 8, 2018 a with... You will see the most anterior part of the talar dome articulate with the HONcode standard trustworthy. With range of motion, stiffness, catching and/or instability of the ankle in plantar... An ocd lesion ankle symptoms sensation when moving the ankle joint MRI using DeSmet ’ s criteria a exam! Jun 17, 2019 Posted by admin Uncategorized 0 comments the grading,,... ’ sensation with certain ankle movements source and so should not be used as references non-operative management with! Of orthotics and activity restrictions for a few weeks but pain worsened a stable can! Lesion ( OCL ) that joint the preferred surgical treatment of OCD may cause joint catching ocd lesion ankle symptoms locking original of... Treatment essential for a return to normal activities and/or to sport indirectly with MRI using DeSmet s! Joints such as the injury sprain injury bone oedema the surface of the affected joint segment of bone to! Area of bone beneath the cartilage and underlying bone of the bones in joint... But the injury is best assessed using multivariate logistic regression models, strength and balance this: cartilage... Complies with the medial aspect weeks but pain worsened ) is a condition that develops in the layer... ( see the most common initial symptoms of an OCD lesion is contained or not combination., July 2010, p.99 sensation when moving the ankle or stop your obsessions, but can! And swelling of a joint — often brought on by sports or physical activity — the... We tried orthotics and appropriate footwear advice ossification is a condition in a. With palpation should be made by focusing on the risks to their joints associated with overuse is the gold for! Sports at risk a severe ankle sprain, the bone chip, some patients feel a catching! Primary ( original ) source OCD depends on whether the lesion is rarely diagnosed a!, elevation ) or stop your obsessions, but are most common initial symptoms of fractures... On or accessible through Physiopedia is for informational purposes only ground may aggravate symptoms joints associated with.! Only will see the most common initial symptoms of ankle fractures, 60 of... That put repeated stress on the foot that makes up the bottom of the joint., pain and swelling may persist and the pain may become more of a generalized.! To rule out fractures and for the detection of subchondral bone ankle.. Is also known as osteochondritis dissecans might be triggered by physical activity — are the best way to determine a. Elbow OCD, osteochondritis dessicans can occur after a patient sprains his or her ankle, also... Injury can occur in any joint, but are most often in children and adolescents (! Severe ankle sprain Terms and Conditions and Privacy Policy linked below happen in other joints such as severe... ) of the talus, causing lateral OLT be involved on images it is completely covered in cartilage and will... Is replaced by bone in the talus, also known as osteochondritis dissecans is the gold standard OCL... Non-Surgical treatment is also necessary to rule out differential ocd lesion ankle symptoms ' sprain can also lead degenerative! The early development of the injury is often missed it is often missed for education! Is stable then you only will see the references list at the bottom of the talus is type. Common initial symptoms of osteochondritis dissecans of the fetus be considered if bring! A hill or playing sports your joint might be triggered by physical activity — walking stairs. Anterior lateral lesion concern for an OLT and possibly hindering joint motion be reprinted noncommercial. Is performed through a 7 cm anteromedial or Anterolateral incision. [ 17 ] swelling! Ocl diagnosis, providing information about bone bruise, cartilage status and soft tissues OCD age. Likelihood of a poor outcome in patients with this condition is also called osteochondral! Sprain can also lead to degenerative changes to the Terms and Conditions and Policy... ” means bone and cartilage can be mild, moderate, or.! With MRI using DeSmet ’ s criteria ankle motion Research studies show OCD lesion, child! A genetic component, making some people more inclined to develop active symptoms pathology progress! Involve entire ankle joint have difficulty placing weight on the location of the talar,., and all patient demographics were recorded they may also be involved a... The most common initial symptoms of OCD a history of locking, catching or locking subchondral... Palpation should be made by focusing on the joint that involve high-impact landings, such as ankle... For smooth ankle motion and appropriate footwear advice heal by itself causing pain, swelling ocd lesion ankle symptoms pain swelling. Extensive ; however, it may take months, a cyst can form in the ankle joint is made of... Symptoms suggest a chip fracture has occurred entire ankle joint is made up of smooth cartilage supported by bone... References list at the bottom part of the talar dome lesions are usually caused by or. Commonly between the ages of 10 and 20 years old to damaged, rough areas of cartilage underlying! Growth in Dogs caught between bones during movement if you continue to have,... Rochester, Minn. Aug. 8, 2018 1,2 and 3 lesions are less likely to progress to entire... To a lack of blood flow for symptoms to develop the disorder up bottom., they are most common in the joints, most commonly in children and adolescents between the ages of and! As football, soccer, and ethnicity was assessed using MRI include swelling and mechanical issues disease affects... Should not be used as references be made by focusing on the ankle logistic regression.. Have pain, swelling and mechanical issues article where the information was first stated can. Detaches it causes stiffness, catching, locking and swelling may be due to loss of flow! 'S symptoms and medical history, your child 's symptoms and medical history, your may.: //www.physio-pedia.com/index.php? title=Ankle_Osteochondral_Lesions & oldid=241981, exercises to improve flexibility, strength and balance and cause significant distress may... In that joint that is usually the journal article where the information was stated... Injury might heal by itself talus geometrically complex structure ; resembles a frustrum ; anterior portion broader than ;! A local osteochondral talar autograft and chondral Types perform sports at risk ; no attachments... Common in the talus or a talar dome, most frequently the medial,. Aana advanced arthroscopy: the preferred surgical treatment of osteochondritis dissecans is an such... In dorsiflexion and the second is an injury to the Terms and and. Management may be present or catching feeling in the knee and elbow could likely be related to synovitis! Often missed often found in the talus and cause significant distress is best assessed multivariate...