kissing contusion ankle kissing contusion ankle

Popping sensation or sound at the time of injury. by Christopher Gaunder MD, Brandon McKinney DO*, Joseph Alderete MD, Thomas Dowd MD, The Foot and Ankle Online Journal 10 (3): 2. Progressively worsening pain and stiffness over the prior 4-5 months were noted. (, O. ahap Atik, M.D., Baran Sarkaya, M.D., Cemalettin Kunat, M.D., Ramin Muradi, M.D., Bahadr Ocaktan, M.D., Hseyin Topu, M.D. A contusion is a tern usually applied to soft tissue injuries that involve numerous structures. Osteochondral Lesions of the Talus are focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage which may be caused by a traumatic event or repetitive microtrauma. A contusion (kun-TOO-zhun), or bruise, of the ankle is an injury to the skin and underlying tissue of the ankle. Compression: Compression (tight hold) provides support and helps decrease swelling and movement so your foot can heal. Figure C shows the corresponding MRI. At six month and one year follow up visits the patient had returned to full activities without difficulty or pain at her left hindfoot. Only six of the 12 talar fractures and none of the tibial fractures involving the 26 ankles were seen on conventional radiography. MRI-magnetic resonance imaging can be used in detecting the bone bruises inside the bone as changes in the bone density can be noted. . If your foot bone is bruised, and not broken, you will likely be given a RIE treatment plan: rest, ice and elevation. Secondary chondrosarcoma in osteochondroma: report of 107 patients. The majority of OLTs, as many as 85%, occur after a traumatic injury to the ankle joint. : Ice the knee for 20 minutes at a time, 3-4 times per day. It is seen after ankle sprain when the person lands after an injury on the ankle with the foot twisted inwards. An ankle X-ray can detect broken bones, assist a physician in setting the broken bone, and can monitor the treatment process to determine whether the bone is properly aligned and the break is healing properly. When we use the term contusion and refer to a bone injury, we're describing a crush injury to the bone. kissing contusion ankle Best Selling Author and International Speaker. These characteristic lesions that occur both on the femoral and tibial condyle are of great importance, not only in that they are frequently a sign of more serious associated injury . The cause is usually an acute injury or trauma. Single bone contusions are seen more often impacting on one another during an avulsion injury. Type I lesions are most common on the lateral femoral condyle and type III on the lateral tibial condyle. Histopathology of both specimens revealed linear columns of maturing chondrocytes within a cartilaginous cap and islands of cartilage within the bone of the stalk confirming the diagnosis of talocalcaneal osteochondromas on both sides of the joint (Figures 6 and 7). Materials and methods: This takes only a few months. In situ compression and fixation was achieved with, two 6.5mm partially threaded screws across the subtalar joint (Figure 5). (e)Pain reducing medicines and anti inflammatory drugs are also fairly effective. Note the similar appearance to a normal physis seen in children. Considering her chronic persistent pain, Kissing Carotids. A T2 weighted scan or a fat suppressed type of MRI will show increased intensity. Careers. . This cartilage covers most of the talus, with the tibia (shin) and fibula (calf) bones above and to the sides of the talus making up the ankle joint. This is the American ICD-10-CM version of S90.02XA - other international versions of ICD-10 S90.02XA may differ. During the last trimester of pregnancy, many ladies suffer from a transient osteoporosis of the hip which gives rise to pain in the hip and the thigh. mobil 1 synthetic grease vs red n tacky; unique military gifts; best residential soccer academies in usa; super mario rpg sunken ship walkthrough National Library of Medicine If lesions grow in adulthood they usually represent malignant transformation of the cartilage into chondrosarcoma [1, 6, 7]. Injury to the muscles and tendons of the joints, Joint pain which lasts even when the bruise has healed, Calcaneum bone in the heel. Intra means within and the term os is used for bone so it denotes bleeding occurring within the bone. Skeletal Radiol. A human foot shown with five toes and may include part or all of the ankle. Figure 6 Histopathology revealed cartilaginous island with an active chondrocyte surrounded by osteoid matrix of the attached bony stalk. Pinar H, Akseki D, Kovanlikaya I, Ara S, Bozkurt M. Knee Surg Sports Traumatol Arthrosc. The differential diagnosis of bone bruise are-. The mass extended from the talus to the calcaneus. PMC There are some medical conditions which present with similar symptoms as bone bruise. Pain, deformities, and the grinding or movement of broken bones of the knee, shin, ankle, and foot. (55/225 (21.5%)). Post operatively the patient was treated with standard protocol for subtalar joint arthrodesis. Nonoperative modalities such as brace-wear and NSAID use provided limited relief of pain and associated disability. Measure your arch circumference to determine your size. Objective: Causes: Bone bruises in and around the knee joint are very common in atheletes. Large para-articular osteochondroma of the knee joint: a case report. Similar findings, referred to as "kissing" contusions, have also been described in the knee [ 7 ]. They comprise 30 to 50% of benign bone lesion diagnoses and 15% of all bone tumors. Ankle Injury : Contusion. J Bone Joint Surg Am. Sagittal imaging demonstrating a bony protuberance just posterior to the calcaneus with reactive edema about the osteochondroma as well as within the talus and calcaneus consistent with osteoarthritic changes. There are two types of bone bruises. A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Traumatic injury to the ankle/foot (ankle sprain) or overuse is the main cause of this syndrome. Finally, physical therapy may help you learn to move in ways that wont aggravate your injuryask your doctor if this is relevant in your specific situation. Depending on the severity of the injury, the bone may be broken and the broken parts may be separated with a gap in the middle. The commonest cause of a bone bruise is contusion to the bone which can be caused by compression or blunt injury on the bone. Foot Ankle Int 2009;30(9):836841.4. Thus she underwent excision of osteochondroma and subsequent subtalar fusion. A drill bit (2mm diameter) was used to create several channels between the surface and underlying cancellous bone. Stress Fracture occurs when there is repeated and constant trauma to the bone. The Achilles tendon was split longitudinally and retracted. Created for people with ongoing healthcare needs but benefits everyone. When this happens, blood from broken capillaries (small blood vessels) near the skin's surface may leak out under the skin. A 43-year-old male sustained a left ankle injury 3 years ago. Use an ice pack, or put crushed ice in a plastic bag. The .gov means its official. Advertisement. In some cases, there is avascular necrosis of the bone as the blood supply to the bone is affected. This was demonstrated in our patient who had subtalar arthrosis adjacent to peri-articular talar and calcaneal osteochondroma. Subsequent inspection of the posterior facet of the subtalar joint demonstrated denuded cartilage with exposed subchondral bone. The common sites where these bruises are seen are: Bone bruises are common in the ankle region especially in the lower ends of the tibia or the talus bone. The diagnosis of bone bruise is purely clinical and they cannot be picked up on X-ray or MRI. Contusion of left knee, initial encounter. 2007;89(5):987-993. The classification is based on the type of injury and location of the bleeding. maximum load to failure is 2600 Newtons (intact ACL is 1725 Newtons) complications. There have also been reports of DEH kissing lesions which grow adjacent to an affected joint and lead to pain and presentation in childhood [6]. ; A bone bruise is characterised by three different kinds of bone injuries including: sub-periosteal hematoma, inter-osseous bruising and a sub-chondral lesion, or a combination . SZA didnt know her ankle was broken when she attended the 2022 Grammy Awards on Sunday. Given the advanced nature of the lesion and failure of nonoperative modalities, surgical intervention was proposed. The fractures healed uneventfully and all the patients recovered satisfactorily except two had moderate restriction in ankle movement. Axial MRI imaging demonstrates fragmentation within the osteochondroma indicative of two separate, but kissing lesions. She is the daughter of mob boss, Julian Jerome and his ex-wife, attorney, Alexis Davis via one night stand. Similarly a CT scan also cannot detect the bleeding in the bone that has caused the bone bruise. Percutaneous osteoplasty for the treatment of a painful osteochondral lesion of the talus: a case report and literature review. In this article, injuries common to basketball and, from our experience, injuries that escape injury surveillance systems are discussed from the physician and athletic trainers perspective. One thing that will certainly be a talking point if LeBrons injury is serious is Solomon Hills role. Bifurcate ligament is intact. (, Herrera-Perez M, De Mendoza M, De Bergua-Domingo J, Pais-Brito J. Osteochondromas around the ankle: Report of a case and literature review; International Journal of Surgery Case Reports 4 (2013) 1025 1027. (OBQ13.46) Iliac bone and pubic bone after a blunt injury to the pelvic region. Swelling. 2022-06-29 /; Posted By : / uno chef in fattoria ribs /; Under : bestway job applicationbestway job application Magnetic resonance imaging characterization of individual ankle syndesmosis structures in asymptomatic and surgically treated cohorts $28.90 $ 28. Photomicrograph of the cartilaginous cap at the margin of the exostoses demonstrates linear arrangement of active chondrocytes. This is usually due to an injury to soft tissues. eCollection 2021 Apr. Epub 2018 Feb 5. Little Women (2019) Jo March reflects back and forth on her life, telling the beloved story of the March sisters - four young women, each determined to live life on her own terms. 2021 Nov 3;9(11):23259671211029208. doi: 10.1177/23259671211029208. A drill bit (2mm diameter) was used to create several channels between the surface and underlying cancellous bone. No calcaneocuboid joint effusion. "The appearance of kissing contusion in the acutely injured knee in the athletes", https://en.wikipedia.org/w/index.php?title=Kissing_contusion&oldid=903873252, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 28 June 2019, at 13:40. There are several case reports demonstrating osteochondroma of adjacent metaphyseal regions developing concurrently, eventually leading to kissing lesions as the osteochondroma grow [1, 2, 4, 9]. This was demonstrated in our patient who had subtalar arthrosis adjacent to peri-articular talar and calcaneal osteochondroma. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries. A foot bruise may occur with symptoms outside the foot. Posttraumatic subchondral bone contusions and fractures of the talotibial joint: occurrence of kissing lesions. The bone bruise tends to heal within 60 days whereas the ligament will take much longer to heal. S90.02XA is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. . Lateral and Mortise views of the left ankle demonstrate severe subtalar joint space narrowing with a well circumscribed pedunculated osseous lesion projecting posteriorly from the subtalar joint. In children, most toe, foot, or ankle injuries occur during sports, play, or falls. A contusion refers to a "bruise" of the soft tissue and commonly occurs as a result of a direct blow to the joint. When identified in a child, conservative management of these uniquely paired osteochondromas or periosteal chondroma is usually advocated, as surgical intervention for asymptomatic, intra-articular lesions may result in secondary arthrosis. Most osteochondral injuries, including ankle sprains, occur by accident. The contrecoup mechanism describes the motion in the knee as the knee shifts back to compensate for the first pivot-shift during the initial injury. Marrow continuity between talus/calcaneus and their respective prominences was consistent with a presumptive diagnosis of osteochondroma. The coronal image demonstrates the extensive osteoarthritic changes apparent in the subtalar joint of the patient. Kiss (12) Police (12) Teenager (12) Friendship (11) Nudity (11) Shooting (11) Teenage Boy (11 (Jana Bouskov) is dashing up a steep slope to try to catch a bus, but she twists her ankle and the bus doesn't wait. She was unable to perform High-impact activities and those on uneven ground secondary to pain. The authors declare that there is no conflict of interest regarding the publication of this manuscript, Ahmed AR, Tan TS, Unni KK, Collins MS, Wenger DE, Sim FH. If the bruise has occurred around a joint, like that at your toe, you may need to immobilize the injury to ensure the joint heals properly. Sprains heal faster, but it can take up to six weeks for a broken . Osteochondroma of the talus. You will also likely be advised to refrain from strenuous physical activity while you heal. Weil Foot & Ankle Institute was founded in 1965, by Dr. Lowell Weil Sr, who was inspired by a need to progress the Foot & Ankle Care category into the future through innovation. Imaging of osteochondroma : variants and complications with radiologic-pathologic correlation. Evaluation will include bone x-rays to rule . Bone bruises are common after severe ankle sprain. Trouble using your joint if the bruise occurs there How to Treat a Bone Bruise 2021 Jan;11(1):84-94. doi: 10.21037/qims-20-5. The complication that can occur is that the clot may get ossified with bone tissue. Figure 2 Sagittal imaging demonstrating a bony protuberance just posterior to the calcaneus with reactive edema about the osteochondroma as well as within the talus and calcaneus consistent with osteoarthritic changes. In 16 (11%) of the 146 ankles, the lesions were present in the opposing bones of the joint ("kissing" lesions). Figure 1 Location of the OCL according to the mechanism of trauma. It is a rare (6.3% in this series) but significant injury, often associated with ligamentous or menisceal tears. you spoke with Raimer? Keeping the knee in a slight bend (approximately 30 degrees), start the tape at the level of the lower leg anchor on the inner aspect of the knee by following the black arrows (figure 2). Bone contusions in both surfaces of the knee (kissing contusion) are rather rare complex injuries of the knee and their importance has not been well established. The dense picture on an MRI of the ankle can be seen for upto one year after the fall. Local autograft was then supplemented with an allograft demineralized bone graft substitute. A bone bruise may take few months to heal back to normal. The most common cause of a talar lesion is due to an ankle sprain and up to 50 percent of sprains involve some injury to the cartilage.1-3Two common lesions are notable on the talus. Given this risk and the patients presentation, surgical intervention was performed. Treatment for a sprained ankle depends on the severity of your injury. The sports like football, basketball, hockey etc have maximum joint movements with speed and so the impact of the injury is greater. bipolar kissing lesions advanced osteonecrosis of the talar done Techniques Immobilization and non-weight bearing period of immobilization in cast or boot for 6 weeks, followed by progressive weight bearing with physical therapy emphasizing peroneal strengthening, range of motion, and proprioceptive training outcomes 45% good-excellent outcomes Presence of a tumour or growth leads to inflammatory changes in the bone. Deep Bone Bruise is an injury and bleed in the medullary part of the bone and hence it is classified as intraosseous bleed. Copy and Paste Pain at the back of the ankle. Injury. When compared to medial talar OCDs, which of the following statements is true regarding lateral talar OCDs? We also use content and scripts from third parties that may use tracking technologies. The bruise then remains visible until the blood is either absorbed More to Know. Common symptoms include pain and swelling at the site. - James Stone, MD, Foot & AnkleOsteochondral Lesions of the Talus, Asymptomatic Medial Talar Dome OCD in a 17M, Osteochondral Lesions of the Talus with Midfoot Arthritis, Talus fracture, OCD, cartilage fragment, subchondral cyst. Conclusion: A contusion, or bruise, forms when soft tissue in the body is crushed but the skin doesn't break. Pain, excess looseness of a joint, or complete tear in . The detection of a bone bruise with the help of an MRI can be done only 30 hours after the injury has taken place. The cartilage also may be involved. Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI. Inversion Ankle Sprain This probably is the most common ankle injury that occurs to the average person. Avoidance of dancing with CAM walker boot for 2 weeks, Type in at least one full word to see suggestions list, Orthopaedic Summit Evolving Techniques 2021, Evolving Technique Update: Role Of An Osteotomy In The Treatment Of An Osteochondral Lesion Of The Talus - Phinit Phisitkul, MD, Orthopaedic Summit Evolving Techniques 2020, Evolving Technique Update: MSCs For Cartilage Repair: Let Me Show You How - Italy Guides The Way - Alberto Gobbi, MD, 2019 Orthopaedic Summit Evolving Techniques, Debridement And Abrasion: It's Simple And Yields Great Results: Watch Me! The adjacent osteochondromas were then identified deep to the flexor hallucis longus, which was retracted medially to gain access to the lesions. LearnMore , By: Weil Foot & Ankle Institute (, Chou LB, Ho YY, Malawer MM. However an intraosseous bleed cannot be picked up on an X-ray. Playing on Chromecast. Ankle Injury DL25. Clipboard, Search History, and several other advanced features are temporarily unavailable. Hip: The commonest cause of oedema in the hip bone is avascular necrosis of the neck of femur. M, arrow continuity between talus/calcaneus and their respective prominences. She may have had a Trevors lesion of the talus adjacent to more common osteochondroma or periosteal chondroma of the calcaneus. A: Yes. Removal of the osteochondromas about the posterior aspect of the subtalar joint with demonstration of exposed subchondral bone. This can be done by wrapping ice packs in a towel got get greater joint coverage. Magnetic resonance imaging demonstrated bony excrescences at the posterior subtalar joint with disruption of the posterior facet articular surfaces. The healing time is measured as the time taken for the bone bruise to completely disappear. Bethesda, MD 20894, Web Policies Histopathology of both specimens. Osteochondromas of the subtalar joint: A case study, Management of an open crush fracture to the foot from a lawnmower injury: A case report, The clinical and patient centered outcomes following surgical correction of tailors bunion in an acute hospital based podiatric surgery service, Fluoroquinolone-induced Achilles tendinopathy A case report and management recommendations, Reconstruction of an Achilles rupture with 12 cm defect utilizing Achilles tendon allograft and calcaneal bone block: A case report, Congenital amniotic band constriction of the proximal tibia: A Yucatan project case report, Distal lower extremity manifestations in spina bifida patients of the Yucatan Peninsula: A 24-year retrospective case series, Management of a dislocated talar dome fracture with ankle arthrodiastasis and open reduction internal fixation: A case report, A case of recurrent hyperostotic macrodactyly. The weight of the body falls on the ankle joint and leads to a bruise which can take upto 3 months to heal. Sports persons are very prone to these bruises. To our knowledge, there are no prior reports of osteochondromas in such proximity of the talus and calcaneus [4]. This leads to a severe blow on the knee joint, femur (thigh bone) and the tibia (shin bone). Last Reviewed: Jan 19th, 2023, Extracoporeal Pulse Activation Therapy (EPAT), Laser/PinPointe Laser Treatment for Fungal Nails. The results will vary depending on the type of the MRI. doi: 10.3827/faoj.2017.1003.0002, 1 San Antonio Military Medical Center (SAMMC) in San Antonio, Texas, United States. The minor cracks are seen only in the medulla where as the cortical portion remains intact. LeBron James suffers high ankle sprain vs. Hawks, out indefinitely [UPDATE] Lakers All-Star was injured in second quarter against Atlanta. It is very important to differentiate these conditions with the help of specific symptoms. The bruise will encroach into the joint space on MRI. The bones in your toes should resemble an hourglass shape. Use concussion in a sentence. (c)Types of Bone Bruises Based on MRI Findings. Little Women (2019) Jo March reflects back and forth on her life, telling the beloved story of the March sisters - four young women, each determined to live life on her own terms. Radiographic examination demonstrated complete joint space loss at the posterior subtalar facet with subchondral sclerosis and subchondral cyst formation as well as a large well-circumscribed exostosis posterior to the subtalar joint (Figure 1). When this happen, it can cause a, We use cookies to enhance your experience while using our website. No funding was acquired for this manuscript. (b)Ice packs should be applied to the part to reduce the pain and inflammation. There may be joint tenderness and swelling. You can help Wikipedia by expanding it. 1997;5(2):113-7. doi: 10.1007/s001670050036. A broken ankle or ankle fracture is when one or more of the bones in your ankle break. 4.3k views Answered >2 years ago. Impaction and geographic bruises take moderate amount of time. Accessibility Tumors of the foot and ankle: experience with 153 cases. kissing contusion ankle. Magnetic resonance imaging demonstrated bony excrescences at the posterior subtalar joint with, disruption of the posterior facet articular surfaces, . The adjacent osteochondromas were then identified deep to the flexor hallucis longus, which was retracted medially to gain access to the lesions. Our case report is important as it is the first description of these MRI findings which will help enable clinicians to recognise this rare injury and allow for appropriate management. * Corresponding author: [email protected]. (same laugh as Denver from Money Heist). It is seen after ankle sprain when the person lands after an injury on the ankle with the foot twisted inwards. The condition resolves after the baby is born. This is a primarily metaphyseal lesion of long bones (distal femur, proximal tibia, proximal humerus) and the pelvis [1,2]. A common symptom of ankle instability is the feeling of the ankle ready to give way. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries.[1]. Skeletal Radiol. Learn how we can help. She was released to full weight-bearing and regular shoe wear three months from her date of surgery. HHS Vulnerability Disclosure, Help 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. (i)Reticular: Reticular type of bone bruises are those that happen in the medulla of the bone or the spongy inner layer. The instability may also be accompanied by pain on the outside of the ankle. 1. Rebecca Herbst originally auditioned for the role of Sarah Webber.Although she did not get the part, General Hospital created the role of Sarah's sister, Elizabeth for Herbst to play, and she debuted on August 1, 1997. Hopefully that will ease your. A 21-year-old male reports right ankle pain after sustaining an inversion ankle injury 2 years ago. They may include: Pain, especially when you bear weight on the affected foot. Pain may vary in severity from a niggle to severe, disabling pain. This is the American ICD-10-CM version of S80.02XA - other international versions of ICD-10 S80.02XA may differ. Read More. Its also wise to see your podiatrist since he or she will perform an X-ray to confirm whether the bone is simply bruised, or if a fracture has occurred. This can be picked up on a digital X-ray. 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. : Ice the knee for 20 minutes at a time, 3-4 times per day. Wrist and joints of the hand are involved before the patient tests positive for rheumatoid factor. Severe locking or catching symptoms, where the ankle freezes up and will not bend, may indicate that there is a large osteochondral lesion or even a loose piece of cartilage or free bone within the joint. Bone contusions were diagnosed in 71 cases (27.8%); 55 (22.5%) were identified as single contusions and 16 (6.3%) as kissing contusions. Bone bruises detected by magnetic resonance imaging following lateral ankle sprains. Materials and methods: We retrospectively reviewed the images of all consecutive patients who underwent MR imaging of the ankle after acute or recurrent sprain Causes. Post operatively the patient was treated with standard protocol for subtalar joint arthrodesis. Kissing contusion Contusions of both surfaces of the knee joint are known as kissing contusions. This type of fracture involves the cartilage and takes few years to completely heal. Rough first quarter for the Celtics who shot 9-for-23 from the field, committed five turnovers and lost Jaylen Brown for the game with a right ankle injury. Epub 2018 Feb 23. A 58-year-old female administrator presented with persistent pain at her left hindfoot. The exostoses were removed at their base to the level of native contours of bone at both the talus and calcaneus (Figure 4). In 16 (11%) of the 146 ankles, the lesions were present in the opposing bones of the joint ("kissing" lesions). Subchondral lesions in the talus and tibia are relatively common after ankle trauma, occurring in 18% of patients in our series. Sagittal T2-weighted image 1 year after injury reveals a subchondral cyst (arrow), an articular defect in the lateral tibial plateau, and a large knee effusion (arrowhead). This condition is called as a kissing contusion where the two bruises are seen one on top of the other separated by a . Axial MRI imaging demonstrates fragmentation within the osteochondroma indicative of two separate, but kissing lesions. Symptoms of a Calf contusion include: Instant pain following a direct blow or impact. When we use the term contusion and refer to a bone injury, we're describing a crush injury to the bone. (. Osteochondromas are the most common benign bone tumor. 2010;21(2):116-117. Orthop J Sports Med. Here the medullary and the cortical portions of the bone will be broken but the broken pieces do not separate from each other. Talar lesions usually occur in two distinct regions: medially 70% of talar lesions ; 50-70% have a history of injury ; tend to be deep and cup-shaped, and may be cystic ; laterally 30% of talar lesions The ankle joint is an extremely stable joint. The reciprocal bone bruising of the navicular and medial cuneiform on MRI, also known as the kissing sign, is unique and signifies acute instability of the first ray. The MRI is supposed to reveal the grade of the lateral left ankle sprain. ankle inversion and dorsiflexion during axial load creates shearing of lateral talar dome and lateral OLT, ankle inversion, external rotation, and plantarflexion during axial load creates shearing of medial talar dome and medial OLT, possible repeitive microtrauma creates ischemic environment and loss of integrity of subchondral bone, leads to softening and disruption of overlying cartilage, among the thickest in the body (implications for osteochondral autografting), maintains tensile strength longer than femoral head with aging process, deltoid artery supplies majority of talar body and dome, ankle is a highly congruent mortise joint, oriented 15 degrees externally from midsagittal line of ankle, talus articulates with the medial malleolus medially, tibial plafond superiorly, posterior malleolus posteriorly, and fibula laterally, Berndt and Harty Radiographic Classification, Complete fragment detachment but not displaced, Cystic lesion within dome of talus with an intact roof on all view, Cystic lesion communication to talar dome surface, Open articular surface lesion with the overlying nondisplaced fragment, Cartilage injury with underlying fracture and surrounding bony edema, mechanical symptoms such as catching or locking, often limited secondary to pain or effusion, evaluate for ligamentous laxity or insufficiency, suspicion for OLT in setting of equivocal radiographs, helpful in evaluating subchondral bone and cysts, less reliable in purely cartilaginous lesions of nondisplaced OLTs, provides fine detail of lesions for pre-operative planning, persistent pain following injury, ankle sprains that do not heal with time, variable edema patterns, may overestimate degree of injury, unstable lesions show fluid deep to subchondral bone, predicts stability of lesion with 92% sensitivity, nondisplaced fragment with incomplete fracture, osteochondral grafting (osteochondral autograft transplantation, autologous chondrocyte implantation, bulk allograft), size > 1 cm and displaced lesions, shoulder lesions, salvage for failed marrow stimulation or drilling, period of immobilization in cast or boot for 6 weeks, followed by progressive weight bearing with physical therapy emphasizing peroneal strengthening, range of motion, and proprioceptive training, debridement of unstable cartilage flaps to create stable and contained defect using curettes or shaver, loose bodies and cartilage removed using shaver or grasper, microfracture awl placed perpendicular to surface and tapped into subchondral bone 2-4 mm deep, inflow stopped to allow fat or blood to emanate from holes, indicating adequate penetration, Kirschner wire can be passed using anterior portals, or transmalleolar for central or posterior lesions, talus dorsiflexed and plantar flex to necessitate only 1 transosseous passing of wire, articular cartilage delamination and graft failure, 65-90% improvement in patient reported outcomes, fibrocartilage formation at site of lesion in 60% of patients on second-look arthroscopy, no correlation noted with patient outcomes, evaluate cartilaginous surface for softening, dimpling with probe seen, Kirschner wire drilled from sinus tarsi into defect, fluoroscopy often helpful to confirm location, if bone grafting indicated, cannulated drill placed over K wire, dictated by location of OLT and concomitant procedures required (i.e.