11/9/2023 0 Comments Malleolus lateral![]() with paracetamol and nonsteroidal anti-inflammatory drugs 6. Non-operative management involves patient education, lifestyle and activity modifications including weight loss, physical therapy and pain management e.g. The main objectivities in the treatment of ankle osteoarthritis are pain control and functional maintenance or restoration like in other joints. The MRI report should mention the following additional feature: subchondral fractures, signs of osteonecrosis, avulsions presence of subchondral cysts and/or bone erosion.joint space narrowing and joint space width.presence and the location of osteophyte formation.The radiological report should include a description of the following: MR arthrography can be used in situations where there are no metallic components. CT/MR arthrographyĬT arthrography is the imaging modality of choice in cartilage evaluation in the postoperative ankle joint to rule out early osteoarthritis. It can also detect underlying aetiologies including ligament and tendon injuries osteochondral lesions as well as ankle impingement syndromes or signs of previous surgery 5. In addition to osteophyte formation, joint space narrowing and subchondral sclerosis and subchondral cysts as well as kissing lesions MRI can detect joint effusion, synovitis and bone marrow oedema as a possible cause of pain. Kellgren and Lawrence grade ≥1 is consistent with ankle osteoarthritis.Ī grading of different features of osteoarthritis can be also achieved by using the OARSI atlas 3. It is considered reliable and has been shown to correlate with clinical symptoms 4. grade 3: osteophytes on the medial and/or lateral malleolus, moderate joint space narrowing 50%) joint space narrowing, constant tibiotalar sclerosis.grade 2: osteophytes on the medial malleolus, no joint space narrowing.grade1: osteophytes of questionable significance on the medial or lateral malleolus, rare tibial sclerosis, no joint space narrowing.The Kellgren and Lawrence score has been modified for the ankle joint 4: The medial, superior tibiotalar space and tibiofibular joint space are evaluated. ![]() The Saltzmann view can be acquired for the evaluation of hindfoot alignment 1. Weight-bearing AP and lateral views of the ankle and mortise views are done for the assessment of osteoarthritis. Like in other joints osteoarthritis of the ankle is characterised by osteophyte formation joint space narrowing, subchondral sclerosis and subchondral cyst formation, remodelling of the articular surfaces or deformity in more advanced stages 3,4. haemochromatosis, haemophilia, neuropathic disease.rheumatoid arthritis, gout or septic arthritis osteochondral lesions, osteonecrosis of the talus.previous trauma, fractures or ligamentous injuries.Unlike in knee or hip osteoarthritis, primary osteoarthritis of the ankle is rare and secondary osteoarthritis is much more common including the following causes 1: Osteoarthritis is characterised by progressive joint alteration, due to a combination of mechanical, inflammatory and metabolical factors affecting the hyaline cartilage, the subchondral bone, the joint capsule and the synovium as well as the surrounding ligaments 1. Joint instability and pain-related psychological stress are additional symptoms. Pain might be described as weather dependant or occur at night, it might be closely related to sportive activities and remaining hours to days after cessation 1. The typical complaint is pain and impaired function of the ankle joint. The latency between a significant trauma and development of end-stage osteoarthritis is very variable with an average of about 21 years 1. Risk factorsĪctivities with an increased risk of ankle osteoarthritis include 1:Īnkle osteoarthritis is primarily associated with previous traumatic events as well as chronic ankle instability or subtalar instability 1. Ankle osteoarthritis is uncommon in the general population and prevalence is estimated at ~1% 1.
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