Osteochondral Lesions of the Talus Clinical Presentation

Updated: Mar 16, 2023
  • Author: Christopher F Hyer, DPM, FACFAS; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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In most cases, the mechanism of injury for an osteochondral lesion of the talus (OLT) is an inversion injury with simultaneous or preexisting disruption of the lateral ligamentous complex. Patients typically present with chronic ankle pain along with intermittent swelling and, possibly, weakness, stiffness, instability, and giving way.


Physical Examination

Upon physical examination, assess joint laxity with the anterior drawer test, and assess strength by comparison with the contralateral ankle. Physical examination findings of joint laxity are uncommon. Palpation may reveal tenderness behind the medial malleolus when the ankle is dorsiflexed, indicating a posteromedial lesion. Anterolateral lesions may be tender when the anterolateral ankle joint is palpated with the joint in maximal plantarflexion.