Bone Scan Ankle Osteochondral lesions Bone scan is not the next imaging study in this clinical scenario. Fractures Bone scan is not the next imaging study in this clinical scenario. Bone scan may be used in rare setting in polytrauma cases for evaluation of multiple fractures. CT Ankle Osteochondral lesions Although MRI is the reference standard, CT is also of utility to identify, locate, and quantify cortical and subcortical involvement or loss as well as presence of intra-articular ossific bodies or associated fractures. In a prospective study of 399 patients, uncontained osteochondral lesion of the talus shoulder, as determined arthroscopically, had a more complicated clinical outcome than those with nonshoulder lesions, confirming the importance of imaging localization for clinical outcome [59]. An inverted osteochondral fracture of the lateral talus (lateral, inverted, Acute Trauma to the Ankle fracture talus, also known as the LIFT lesion) can occur after twisting injury to the ankle. Initial radiographs should be followed by CT and MRI [60,61]. These lesions are treated successfully with combined open approach and arthroscopy. Fractures CT is the first-line imaging study after radiographs to determine extent, displacement, comminution, intra-articular extension, associated injuries, and potential classification of fractures [48]. This is particularly important in subtalar, calcaneal, and talar fractures because of the complex anatomy and in high-impact polytrauma or complex comminuted injuries in which multiplanar CT imaging is recommended to help direct the preoperative planning evaluation process [62]. MRI Ankle Osteochondral lesions MRI without IV contrast is considered the study of choice for assessment of cartilage abnormalities and bone contusions related to acquired osteochondral lesion, particularly in patients with symptoms of persistent pain, stiffness, locking, clicking, and ankle swelling [22,55-57,63].
Acute Trauma to the Ankle. Bone Scan Ankle Osteochondral lesions Bone scan is not the next imaging study in this clinical scenario. Fractures Bone scan is not the next imaging study in this clinical scenario. Bone scan may be used in rare setting in polytrauma cases for evaluation of multiple fractures. CT Ankle Osteochondral lesions Although MRI is the reference standard, CT is also of utility to identify, locate, and quantify cortical and subcortical involvement or loss as well as presence of intra-articular ossific bodies or associated fractures. In a prospective study of 399 patients, uncontained osteochondral lesion of the talus shoulder, as determined arthroscopically, had a more complicated clinical outcome than those with nonshoulder lesions, confirming the importance of imaging localization for clinical outcome [59]. An inverted osteochondral fracture of the lateral talus (lateral, inverted, Acute Trauma to the Ankle fracture talus, also known as the LIFT lesion) can occur after twisting injury to the ankle. Initial radiographs should be followed by CT and MRI [60,61]. These lesions are treated successfully with combined open approach and arthroscopy. Fractures CT is the first-line imaging study after radiographs to determine extent, displacement, comminution, intra-articular extension, associated injuries, and potential classification of fractures [48]. This is particularly important in subtalar, calcaneal, and talar fractures because of the complex anatomy and in high-impact polytrauma or complex comminuted injuries in which multiplanar CT imaging is recommended to help direct the preoperative planning evaluation process [62]. MRI Ankle Osteochondral lesions MRI without IV contrast is considered the study of choice for assessment of cartilage abnormalities and bone contusions related to acquired osteochondral lesion, particularly in patients with symptoms of persistent pain, stiffness, locking, clicking, and ankle swelling [22,55-57,63].