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Posttraumatic Subchondral Bone Contusions and Fractures of the Talotibial Joint

Occurrence of "Kissing" Lesions

Elisabeth S. Sijbrandij1, Ad P. G. van Gils1, Jan Willem K. Louwerens2 and Eduard E. de Lange3

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.



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  		Fig. 1A. —31-year-old man 2 weeks after ankle sprain. Anteroposterior radiograph of right ankle shows no abnormal findings.

 


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  		Fig. 1B. —31-year-old man 2 weeks after ankle sprain. Coronal short tau inversion-recovery image (TR/TE, 3600/20; inversion time, 150 msec) shows bone contusions in opposing areas of medial tibia (arrowhead) and medial talar dome (arrow). Contusions are recognized by areas of increased signal intensity.

 


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  		Fig. 1C. —31-year-old man 2 weeks after ankle sprain. Coronal T1-weighted spin-echo MR image (600/23) shows decreased signal intensity (arrow) in medial talar dome.

 


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  		Fig. 2A. —22-year-old man 6 weeks after distortion of left ankle. Anteroposterior radiograph shows no abnormal findings.

 


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  		Fig. 2B. —22-year-old man 6 weeks after distortion of left ankle. Coronal short tau inversion-recovery image (TR/TE, 3600/20; inversion time, 150 msec) shows bone contusion in opposing areas of medial tibial plafond (V) and osteochondral fracture in medial talar dome (arrow).

 


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  		Fig. 2C. —22-year-old man 6 weeks after distortion of left ankle. Sagittal T1-weighted spin-echo MR image (600/23) shows osteochondral fracture in medial talar dome (arrow) and bone contusion in tibial plafond (arrowhead).

 


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  		Fig. 3A. —42-year-old man with persistent pain after recurrent sprains of right ankle. Anteroposterior radiograph of ankle shows osteochondral defect in lateral aspect of talus (arrow).

 


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  		Fig. 3B. —42-year-old man with persistent pain after recurrent sprains of right ankle. Coronal short tau inversion-recovery image (TR/TE, 3600/20; inversion time, 150 msec) shows osteochondral lesion in lateral talus (arrow) and osteochondral lesions in medial tibial plafond (V). Lesions are not diametrically opposed probably as result of rotation during injury.

 


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  		Fig. 3C. —42-year-old man with persistent pain after recurrent sprains of right ankle. Coronal T1-weighted spin-echo MR image (600/23) shows osteochondral fracture in lateral talus (arrow) and osteochondral contusion in medial tibial plafond (arrowhead).

 


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  		Fig. 4A. —25-year-old man 7 weeks after severe sprain of left ankle. Anteroposterior radiograph of left ankle shows no abnormal findings.

 


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  		Fig. 4B. —25-year-old man 7 weeks after severe sprain of left ankle. Coronal short tau inversion-recovery image (TR/TE, 3600/20; inversion time, 150 msec) shows bone contusions in opposing areas of medial tibial plafond (V) and lateral talar dome (arrow). Contusions are recognized by areas of increased signal intensity.

 


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  		Fig. 4C. —25-year-old man 7 weeks after severe sprain of left ankle. Coronal T1-weighted spin-echo MR image (600/23) shows osteochondral contusions in lateral talar dome (arrow) and tibial plafond (arrowhead). Contusions are not diametrically opposed probably as result of rotation.

 

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