Ankle and Foot 47 - Department of Radiology - University of ...
Ankle and Foot 47 - Department of Radiology - University of ... Ankle and Foot 47 - Department of Radiology - University of ...
2266 VII Imaging of the Musculoskeletal System 47 Ankle and Foot 2266 47 Figure 47-75. Osteochondral lesion of the talus (OLT) in a 14-year-old with ankle pain. Anteroposterior (A) and mortise (B) radiographs demonstrate a subtle OLT of the medial talar dome (open arrow). MRI was obtained 2 months later. C, Coronal T1-weighted image demonstrates the OLT of the medial talar dome (open arrow). D, The corresponding coronal T2-weighted fat-suppressed image shows a bright line of fluid (arrows) around the OLT, indicating it is unstable. A B C D A B Figure 47-76. Lateral process of the talus (LPT) fracture in a 17-year-old gymnast who landed awkwardly after a vault. A, Lateral radiograph demonstrates the slightly displaced, transversely oriented LPT fracture (arrowheads). B, Sagittal CT confirms the LPT fracture (arrowheads) seen in A. Given the relatively small size of this fracture, the patient was treated nonoperatively with casting and then with physical therapy. (This scan was performed using an older protocol, with source images 1 mm thick at 1-mm intervals. This lack of overlap yields reformatted images with some stair-step artifacts that can be seen in the metatarsal shaft. This artifact can be avoided by reconstructing source images with a 50% overlap.) Ch047-A05375.indd 2266 9/9/2008 5:35:07 PM
47 Ankle and Foot 2267 47 Figure 47-77. Subtle lateral process of the talus (LPT) fractures in a 28-year-old who sustained multiple injuries from a motor vehicle collision. Lateral radiograph demonstrates a minimally displaced, vertically oriented LPT fracture (arrowhead). A Figure 47-78. Fracture of lateral process of the talus (LPT) in a 22-year-old who walked away from a motor vehicle collision and presented 1 day later with ankle pain. A, Lateral radiograph does not clearly demonstrate the fracture. Incidentally noted is an os trigonum (white arrow) and a bone island (black arrow), both of no clinical significance. B and C, CT scans obtained the same day as A, reformatted in the direct sagittal (B) and oblique coronal (C) planes. Both planes well demonstrate the transverse LPT fracture, with extension into the posterior facet of the subtalar joint (arrowheads). The patient did well after 6 weeks of non–weight bearing, and no surgery was required. B C Ch047-A05375.indd 2267 9/9/2008 5:35:09 PM
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<strong>47</strong> <strong>Ankle</strong> <strong>and</strong> <strong>Foot</strong> 2267 <strong>47</strong><br />
Figure <strong>47</strong>-77. Subtle lateral process <strong>of</strong> the talus (LPT) fractures in a<br />
28-year-old who sustained multiple injuries from a motor vehicle<br />
collision. Lateral radiograph demonstrates a minimally displaced,<br />
vertically oriented LPT fracture (arrowhead).<br />
A<br />
Figure <strong>47</strong>-78. Fracture <strong>of</strong> lateral process <strong>of</strong> the talus<br />
(LPT) in a 22-year-old who walked away from a motor<br />
vehicle collision <strong>and</strong> presented 1 day later with ankle<br />
pain. A, Lateral radiograph does not clearly<br />
demonstrate the fracture. Incidentally noted is an os<br />
trigonum (white arrow) <strong>and</strong> a bone isl<strong>and</strong> (black<br />
arrow), both <strong>of</strong> no clinical significance. B <strong>and</strong> C, CT<br />
scans obtained the same day as A, reformatted in the<br />
direct sagittal (B) <strong>and</strong> oblique coronal (C) planes. Both<br />
planes well demonstrate the transverse LPT fracture,<br />
with extension into the posterior facet <strong>of</strong> the subtalar<br />
joint (arrowheads). The patient did well after 6 weeks<br />
<strong>of</strong> non–weight bearing, <strong>and</strong> no surgery was required.<br />
B<br />
C<br />
Ch0<strong>47</strong>-A05375.indd 2267<br />
9/9/2008 5:35:09 PM
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