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a Sagittal T2-weighted MRI study of an ankle with a reticular bone bruise. The white area in the anterior talus represents bone edema. b Schematic diagram of a reticular bone bruise with intact subchondral bone plate. This type of bone bruise heals from the periphery to the center without complications
The reticular type bone bruise is not continuous with the adjacent
articular surface [6, 38, 65] (Fig. 8).
Dijk, C. Niek; Reilingh, Mikel L.; Zengerink, Maartje; Bergen, Christiaan J. A.Journal: Knee Surgery, Sports Traumatology, Arthroscopy
Issue 5DOI: 10.1007/s00167-010-1064-xPublished: 2010-04-14Institution(s):
University of Amsterdam
Osteochondral defects of the ankle can either heal and remain asymptomatic or progress to deep ankle pain on weight bearing and formation of subchondral bone cysts. The development of a symptomatic OD depends on various factors, including the damage and insufficient repair of the subchondral bone plate. The ankle joint has a high congruency. During loading, compressed cartilage forces its water into the microfractured subchondral bone, leading to a localized high increased flow and pressure of fluid in the subchondral bone. This will result in local osteolysis and can explain the slow development of a subchondral cyst. The pain does not arise from the cartilage lesion, but is most probably caused by repetitive high fluid pressure during walking, which results in stimulation of the highly innervated subchondral bone underneath the cartilage defect. Understanding the natural history of osteochondral defects could lead to the development of strategies for preventing progressive joint damage.
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