Posttraumatic subchondral bone contusions and fractures of the talotibial joint: Occurrence of "kissing" lesions

OBJECTIVE. The objective of this study was to determine the presence and lo cation of subchondral bone contusions, fractures, and "kissing" lesions of the talotibial joint after a sprain of the ankle shown on MR imaging. MATERIALS AND METHODS. We retrospectively reviewed the images of all consec utive patients who underwent MR imaging of the ankle after acute or recurre nt sprain occurring between January and December 1997. The number and locat ion of subchondral contusions or fractures revealed on MR imaging were reco rded, and a comparison was made with the radiographs obtained for each pati ent. RESULTS. Of the 146 ankles, 42 osteochondral lesions were revealed on MR im aging in 26 ankles (18%) involving 23 patients. Twenty-three lesions were l ocalized in the dome of the talus and 19, in the tibiofibular plafond. In 1 6 (11%) of the 146 ankles, the lesions were present in the opposing bones o f the joint ("kissing" lesions). Only six of the 12 talar fractures and non e of the tibial fractures involving the 26 ankles were seen on conventional radiography. CONCLUSION. Subchondral lesions in the talus and tibia are relatively commo n after ankle trauma, occurring in 18% of patients in our series. Kissing l esions were present in more than half of the lesions in these patients.