MediAI

Osteochondral Lesion of the Talus: MRI Diagnosis, Imaging Pearls, AI Applications, and Future Directions Introduction Ankle sprains are among the most common musculoskeletal injuries worldwide, accounting for millions of emergency department and outpatient visits each year. While most patients recover uneventfully, a significant subset continues to experience chronic pain, swelling, instability, locking sensations, and reduced athletic performance long after the initial injury. One of the most frequently overlooked causes of persistent ankle symptoms is an osteochondral lesion of the talus (OLT), also known as a talar dome osteochondral defect. These lesions involve injury to both the articular cartilage and underlying subchondral bone and may progress to chronic disability and premature ankle osteoarthritis if not diagnosed early. The presented case involves a 35-year-old woman with persistent ankle pain 10 months after an inversion injury. Radiographs demonstrated a lucent defect in ...

  Abstract Traumatic osteochondral injury (TOI) of the talus represents a clinically significant yet frequently underdiagnosed condition, particularly in young, active individuals presenting with persistent ankle pain following inversion injuries. Advances in imaging—especially high-resolution magnetic resonance imaging (MRI)—have substantially improved diagnostic accuracy and treatment planning.  This column provides a comprehensive, evidence-based review of traumatic osteochondral injury, integrating pathophysiology, epidemiology, clinical presentation, imaging findings, differential diagnosis, treatment, and prognosis.  The discussion is anchored in a real-world case study and incorporates detailed radiologic interpretation, quiz-based learning, and contemporary literature. I. Introduction Traumatic osteochondral injury of the talus is a condition involving damage to the articular cartilage and underlying subchondral bone, most commonly following ankle inversion ...