For the past 24 months I’ve had an ankle injury which, after two MRI’s, has been determined to be osteochondritis desiccans.
No other “abnormal” damage has been found to the medial talar, talar contour, no joint effusion, no loose bodies or osteochondral defect. Further the flexor, extensor, Achilles and peroneal tendons show normal signals.
Late last year I went into a cast (3wks plaster/3wks soft) in an attempt to allow the cartiladge to heal over the bone without success.
Now, after 5-6 months of no activity I’m starting to resume training: 1-2hrs of easy to moderate spinning, 3-5miles of light running. Ironically, its the bike that is giving me the most problems. After two hours of spinning a flat course (CT Eagleman) later that night I could not walk on my ankle - it felt like a sprain with a lot of stiffness. After hobbling around the house all night I woke up the next day and it was noticably better.
I have an appointment w/my osteo today to reveiw the MRI’s, but I’m hoping some slowtwitcher’s with experience in this area or someone has a similar injury (god for bid) could offer feedback.
All input will be greatly appreciated…this has become very frustrating and a lot concerning.
Strange. I have the same injury on my right talus bone. It began hurting in October last year. I have been to various doctors over the past year with little success. It was first diagnosed as a stress fracture. 4 months later when I started running easily 2 miles every other day it hurt worse. New doc, new mri new diagnosis. OD of the talus. He had me try physical therapy for a couple months to strengthen the area around the bone to support it. Still hurt. Now the next step is microfracture surgery. I will be having that this Friday, a full year plus since the injury began. Wish I could give you a better outlook but mine never healed to the point where I could train on it. If you have an more specific questions PM me.
I am cramming for an Xray exam right now…so I looked up Osteochondritis Dessicans in my Portable Xray book by Deltoff and Kogon (now mind you it is just the most popular area in the body covered in this book…not my Yochum and Ro books) and under Osteochondritis dessicans:
"-usually in the knee, bilateral 20% of the time(meaning both)
-occurs mostly commonly in young males shortly after epiphyseal closure (how old are you?)
If a loose body is manifested, periodic attacks of pain and locking during knee extension may occur. (which would explain the recuring injury/pain)
truma is postulated cause, there is a gradual seperation of small semi-lunar shape segment of articular cartilage and subarticulare spongiosa, which becomes necrotic (DEATH of tissue) and may migrate into the articular cavity, leaving behind a residual subarticular pit"
----granted trauma can cause this–but I wonder what it really is. Whatever the trauma is maybe some PT to help rebuild the area? I am a Licensed Massage Therapist for 13 yrs and I can tell you that ankle injuries are a mother to work with, so I offer you my I hope you get better soon and don’t forget to look at your nutrition for however you can support the healing stage.
Off to go take that exam…if Osteochondritis is on there…I Thank You
Eileen - thanks for the medical feedback…see my reponses to each point… Are you sure you have the right diagnosis? --99% I’ve had two different osteo specialists review my original MRI
I am cramming for an Xray exam right now…so I looked up Osteochondritis Dessicans in my Portable Xray book by Deltoff and Kogon (now mind you it is just the most popular area in the body covered in this book…not my Yochum and Ro books) and under Osteochondritis dessicans:
"-usually in the knee, bilateral 20% of the time(meaning both) – Yes, this is precisely what the first doctor (sports specialist) said to me, “I usuallly see this in the knee, but not in the ankle” That’s how I was referred to the specialists.
-occurs mostly commonly in young males shortly after epiphyseal closure (how old are you?) – 33. I’ve been racing for 5yrs…this is my first injury.
If a loose body is manifested, periodic attacks of pain and locking during knee extension may occur. (which would explain the recuring injury/pain) – This is also consistent with what the doctor told me. He gave the analogy of a golfer taking a divet out of the ground…there could be a small piece of bone (?) that is “floating” and causing the pain. He said it coudl fall back in place and the pain woudl go away…most current MRI does not show this…but I’ll verify after today’s appt.
truma is postulated cause, there is a gradual seperation of small semi-lunar shape segment of articular cartilage and subarticulare spongiosa, which becomes necrotic (DEATH of tissue) and may migrate into the articular cavity, leaving behind a residual subarticular pit" --Again, consistent with the divot analogy…and the original MRI showed a black area around the bone, signifying inflammation where the “pit” is.
----granted trauma can cause this–but I wonder what it really is. Whatever the trauma is maybe some PT to help rebuild the area? I am a Licensed Massage Therapist for 13 yrs and I can tell you that ankle injuries are a mother to work with, so I offer you my I hope you get better soon and don’t forget to look at your nutrition for however you can support the healing stage. --Regarding nutrition, could you offer some insight on specific foods I should be including that would assist in the healing process?
Off to go take that exam…if Osteochondritis is on there…I Thank You --Good luck with your exam!
OCD does occur at the talus, but is a different process from the at the knee in teens that Eileen refers to above. It is frequently traumatic in origin ie from a bad ankle sprain, but not always.
As far as the diagnosis goes, the one caution that I would have is that MRI is extremely sensitive, and will often show lesions which are not what’s actually causing the problem. The reason I mention this is that if it is really symptomatic, it will usually cause an effusion, though again not always. It sounds like it took 2 MRIs to make the diagnosis, which is also atypical.
If it is OCD causing the problem, there is no perfect solution. If you haven’t already, it is worth trying a course of glucosamine, as it helps some people. Arthroscopy and microfracture, as well as mosaicplasty have been tried, and help some people, but are not perfect solutions.