Staging of osteochondral lesions of the talus : comparison of Cone Beam CT-Arthrography with Magnetic Resonance Imaging

Abstract

Purpose: To evaluate the value of Cone Beam Computed Tomography (CBCT)-Arthrography (CBCT-A) versus Magnetic Resonance Imaging (MRI) for staging of osteochondral lesions of the talus. Material and Methods: 35 consecutive patients with chronic ankle pain and an osteochondral lesion on MRI were included and subsequently underwent CBCT-A. The following parameters were analysed by two reviewers: size of lesion, depth of lesion, degree of detachment, presence of bone marrow oedema on 1.5 Tesla MRI or sclerosis on CBCT-A, presence of subchondral cysts and additional lesions in the tibia. Results: Analysis of CBCT-Arthrography resulted in an upstaging in 17 patients with a statistically significant difference (p<0.05) for the degree of detachment between MRI and CBCT-Arthrography. Conclusions: CBCT-A allows a more precise staging of osteochondral lesion of the talus than 1.5 T MRI. However, because of its exposure to radiation and more invasive nature, MRI is recommended as the initial screening method for evaluation of osteochondral lesions of the ankle. Additional CBCT-A is reserved for selected cases in which surgical treatment is considered.