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Posttraumatic Subchondral Bone Contusions and Fractures of the Talotibial Joint

Occurrence of "Kissing" Lesions

¹ Department of Radiology, University Hospital Utrecht and Central Military Hospital, Heidelberglaan 100, 3509 AA Utrecht, The Netherlands.
² Department of Orthopedics, University Hospital Utrecht and Central Military Hospital, 3509 AA Utrecht, The Netherlands.
³ Department of Radiology, University of Virginia Health Sciences Center, 100 Lee St., Charlottesville, VA 22902.

OBJECTIVE. The objective of this study was to determine the presence and location of subchondral bone contusions, fractures, and "kissing" lesions of the talotibial joint after a sprain of the ankle shown on MR imaging.

MATERIALS AND METHODS. We retrospectively reviewed the images of all consecutive patients who underwent MR imaging of the ankle after acute or recurrent sprain occurring between January and December 1997. The number and location of subchondral contusions or fractures revealed on MR imaging were recorded, and a comparison was made with the radiographs obtained for each patient.

RESULTS. Of the 146 ankles, 42 osteochondral lesions were revealed on MR imaging in 26 ankles (18%) involving 23 patients. Twenty-three lesions were localized in the dome of the talus and 19, in the tibiofibular plafond. In 16 (11%) of the 146 ankles, the lesions were present in the opposing bones of the joint ("kissing" lesions). Only six of the 12 talar fractures and none of the tibial fractures involving the 26 ankles were seen on conventional radiography.

CONCLUSION. Subchondral lesions in the talus and tibia are relatively common after ankle trauma, occurring in 18% of patients in our series. Kissing lesions were present in more than half of the lesions in these patients.

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