Ankle Osteochonridritis

What is Ankle Osteochondritis?
Osteochondritis Dissecans (OCD) is a joint disorder involving the subchondral bone and the overlying articular cartilage. When OCD affects the ankle it is called Ankle Osteochondritis or OCD of the ankle. In Ankle Osteochondritis, it typically occurs in the inner or medial portion of the ankle (Talus). The bone lesions on the lateral or outside portion of the talus occur due to trauma.

Ankle Osteochondritis is often found in young athletes involved in high impact sports like running, gymnastics, hockey, cricket, lacrosse, squash, tennis, weightlifting, football and basketball, which needs a high level of intense training daily and with minimal rest between the activities.

Causes
The exact cause of this condition is still unclear but it has been associated with:

• Activities with repetitive physical trauma and stresses to the bone
• Restriction of blood flow (Ischemia)
• Hereditary and Endocrine factors
• Avascular Necrosis (Loss of blood flow)
• Rapid growth
• Deficiencies and imbalances in ratio of calcium to phosphorus
• Bone Formation problems
• High impact sports like: football etc., pose higher risk of OCD in stressed ankles.
• Genetic defects

Symptoms
The symptoms develops gradually and most patients complain of

• Pain and Swelling of the ankle.
• Advanced cases might cause the joint of catching and locking
• Popping noise
• Buckling or giving way of the ankle
• Restricted range of movement
• Lesions can develop from stable cysts or fissures to unstable fragments
• Sprains and strains of the ankle.

Diagnosis and Treatment
The doctor will do a physical evaluation of the patient, based on the symptoms, limited range of motion, pain or swelling, tenderness and weakness of the ankle.

Some physical examinations performed by the doctor are:

• Checking the patient’s gait or walk.
• Check the weakness of the quadriceps; this might reveal fluid in the joint, tenderness and crepitus.
• Wilson Test: to locate lesions of the femoral condyle.

The following tests are also performed to confirm diagnosis:

• X-rays to get a clear image of the bones to rule out fractures. It also helps in the initial diagnosis and to evaluate the size and location of the lesion.
• Magnetic Resonance Imaging (MRI) will be useful to diagnose the extent of the cartilage injury.
• Computed Tomography (CT) scan is done to measure the alignment and study the complex bone deformities.