Detaillierte Beitrags-Information
| Beitragstitel | Bilateral osteochondritis dissecans of talar heads and medial femoral condyles: a case report |
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| Beitragscode | P076 |
| Autoren | |
| Präsentationsform | Poster |
| Themengebiete |
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| Abstract |
Introduction Osteochondritis dissecans (OCD) is a rare joint disorder defined as osteonecrosis of subchondral bone [1]. Most affected joints are knee, elbow and ankle [2-7]. Simultaneous affection of several joints is an even less frequent condition, usually affecting both knees [8-10]. In 1985, Smith presented a patient with affection of knee and talar dome [11]. Other known cases are both knees and elbows [12], medial femur condyle and opposite patella [13], both elbows and both patella or both elbows and medial femur condyle [14]. Methods We report a case of bilateral OCD of the talar head, associated with bilateral OCD’s of the medial femoral condyles and a review of literature of simultaneous OCD affection of multiple joints. Results A 23-year-old female sustained a diaphyseal fracture of her right tibia. Internal fixation with intramedullary nailing was performed. Radiographs of the lower leg showed the typical image of OCD of the talar head. CT scanner confirmed OCD stage III according to Clanton’s classification [15] on the right side and stage II on the left. She reported subtle bilateral midfoot pain some years ago and in addition medially localized bilateral knee pain since the age of twelve years needing bilateral knee revision for OCD one year before her lower leg injury. Analysis of former radiographs of the feet revealed that OCD of the talar heads classified as stage I lesions was visible some seven years ago. So far a similar case is not known in the literature. Conclusion In our case, bilateral OCD affecting the talar head was an incidental radiographic finding after a lower leg injury in a patient being treated formerly for bilateral OCD of the femoral condyles. Multiple OCD lesions are rare, but unusual joints, such as the talo-navicular joint can be affected. Stage I lesions are commonly treated non-operatively, while with higher stage lesions arthroscopic or open revision with debridement or fragment refixation, autologous matrix-induced chondrogenesis or arthrodesis can be discussed. |