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A Closer Look at Injured Ankles

Today's modern imaging is helping doctors diagnose many problems. X-rays, MRIs, and arthroscopic exams can locate the damage in cases of chronic ankle pain after injury. Each one of these tools shows a something a little different.

Trauma such as ankle sprain can cause osteochondral lesions (OCL). Osteo refers to bone and chondral describes the cartilage. An OCL lesion can happen from an injury with enough force to damage the cartilage and the bone below it. The damage of OCL lesions can be tricky to see.

X-rays can show a fracture in the bone, but they don't show a tear in the cartilage. MRI clearly identifies damage to the cartilage, but it doesn't always show a crack or break in the bone. Looking inside the ankle with an arthroscope gives the doctor a clear view of the joint. Arthroscopic exam shows the condition of the cartilage. It doesn't show the damage beneath the cartilage. This area is called subchondral.

The authors of this study used all three forms of imaging to diagnose ankle pain. They compared which imaging type or combination of imaging worked the best to find the problem. They found that by using ankle arthroscopy along with an MRI they could accurately see the damage to both the bone and the cartilage.

The authors say that even though it's more expensive, combining these two imaging studies is necessary for finding OCL. In cases of chronic ankle pain, OCL is often the problem. The imaging studies show the exact location and help doctors as they go about repairing the damage.

Masato Takao, MD, et al. Osteochondral Lesions of the Talar Dome Associated with Trauma. In Arthroscopy. December 2003. Vol. 19. No. 10. Pp. 1061-1067.

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