Houston Methodist. Leading Medicine

Foot FAQ

Question:

It's amazing the kind of information you can get now about your health problems. I had an MRI done of my ankle after an injury and they sent me home with a CD of the images and a written report. It says I have an osteochondral lesion of the right talus. Can you please interpret what this means for me?

Answer:

Sprains, strains, fractures, and other trauma to the ankle can result in a condition known as osteochondral lesions of the talus or OLT. The talus is the bone located below the tibia (lower leg bone) and above the calcaneus (heel). The lesion or defect can affect just the cartilage lining the bone (called a chondral lesion) or the hole can go all the way down to the bone (an osteochondral defect). It is important to know what type of lesion is present. Patients with osteochondral lesions have a better chance of self-healing compared with those who have the chondral type. This is because bone marrow cells (inside the bone) can move or migrate from inside the bone to the defect and stimulate healing. Chondral lesions don't have that direct connection to bone marrow cells and must rely on far fewer bone marrow cells reaching the lesion. The cells come from the joint synovial membrane (lining around the joint containing fluid). According to some studies, osteochondral lesions are more common in younger (more active) adults (in their 20s) who might have better healing capabilities as well. Chondral (cartilage only) lesions are present more often in older, heavier adults (50 year old and older with higher body mass index or BMI). Trauma is often a key feature affecting most patients with either type of lesions. Symptoms may last longer in patients with the chondral type of lesions -- possibly because of the delayed healing with reduced self-healing associated with this type of injury. Chondral lesions in patients without a history of trauma are more likely to form cysts just under the cartilage. Older patients are more likely to experience impingement (pinching) of the soft tissues during ankle motion with the chondral type of lesions. Patients in both groups have equally improved symptoms (decreased pain and increased function) after surgery for either kind of lesion. Most likely, when you go back to the surgeon for your follow-up visit, the results of the testing will be explained. You'll have an opportunity to ask questions at that time. Hopefully, this information will aid you in understanding the basics of this condition so that you can ask more about your own specific situation. Gi Won Choi, MD, et al. Osteochondral Lesions of the Talus. In The American Journal of Sports Medicine. March 2013. Vol. 41. No. 3. Pp.504-510.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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