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Osteochondral lesion of the talus.
The initial MRI (figure 3) identified subchondral oedema-like signal of the medial talus on the fluid-sensitive short tau inversion recovery (STIR) sequence. The T1-weighted sequence was normal. A small effusion was present and the talar cartilage, ligaments and tendons were normal (not shown).
Anteroposterior and lateral plain radiographs obtained at 18 months (figure 4) identified a 7 mm subchondral cyst within the medial talar dome. The talar dome was intact and there was no collapse of the cortex.
The second MRI (figure 5) showed a predominately high-T2 signal, low-T1 signal lesion within the subcortical bone corresponding to the original area of oedema-like signal in the presentation MRI (figure 3) and the cystic lucency on the 18 months radiograph (figure 4). A curvilinear focus of high signal immediately beneath the hyaline cartilage (figure 5A,B) was a component of the subchondral cyst rather than chondral separation. The joint effusion had increased marginally in size and small loose bodies were present (not shown).
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