Fortschr Röntgenstr 2017; 189(10): 945-956
DOI: 10.1055/s-0043-110861
© Georg Thieme Verlag KG Stuttgart · New York

Modern Cartilage Imaging of the Ankle

Article in several languages: English | deutsch
Marc-André Weber
1  University Hospital Heidelberg, Diagnostic and Interventional Radiology, Heidelberg, Germany
Felix Wünnemann
1  University Hospital Heidelberg, Diagnostic and Interventional Radiology, Heidelberg, Germany
Pia M. Jungmann
2  Radiology, Technical University of Munich, Germany
Benita Kuni
3  Orthopedics and Trauma Surgery, Ortho-Zentrum Karlsruhe, Germany
Christoph Rehnitz
1  University Hospital Heidelberg, Diagnostic and Interventional Radiology, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

23 November 2016

08 April 2017

Publication Date:
11 July 2017 (eFirst)


Background Talar osteochondral lesions are an important risk factor for the development of talar osteoarthritis. Furthermore, osteochondral lesions might explain persistent ankle pain. Early diagnosis of accompanying chondral defects is important to establish the optimal therapy strategy and thereby delaying or preventing the onset of osteoarthritis. The purpose of this review is to explain modern cartilage imaging with emphasis of MR imaging as well as the discussion of more sophisticated imaging studies like CT-arthrography or functional MR imaging.

Methods Pubmed literature search concerning: osteochondral lesions, cartilage damage, ankle joint, talus, 2 D MR imaging, 3 D MR imaging, cartilage MR imaging, CT-arthrography, cartilage repair, microfracture, OATS, MACT.

Results and Conclusion Dedicated MR imaging protocols to delineate talar cartilage and the appearance of acute and chronic osteochondral lesions were discussed. Recent developments of MR imaging, such as isotropic 3 D imaging that has a higher signal-to noise ratio when compared to 2 D imaging, and specialized imaging methods such as CT-arthrography as well as functional MR imaging were introduced. Several classifications schemes and imaging findings of osteochondral lesions that influence the conservative or surgical therapy strategy were discussed. MRI enables after surgery the non-invasive assessment of the repair tissue and the success of implantation.

Key points

  • Modern MRI allows for highly resolved visualization of the articular cartilage of the ankle joint and of subchondral pathologies.

  • Recent advances in MRI include 3 D isotropic ankle joint imaging, which deliver higher signal-to-noise ratios of the cartilage and less partial volume artifacts when compared with standard 2 D sequences.

  • In case of osteochondral lesions MRI is beneficial for assessing the stability of the osteochondral fragment and for this discontinuity of the cartilage layer is an important factor.

  • CT-arthrography can be used in case of contraindications of MRI and in unclear MRI findings as further diagnostic approach.

Citation Format

  • Weber MA, Wünnemann F, Jungmann PM et al. Modern Cartilage Imaging of the Ankle. Fortschr Röntgenstr 2017; 189: 945 – 956