Osteochondritis dissecans (OD)

A frequent but little known complaint. It is not usually diagnosed as it used to be established only by surgery or autopsy, while today MRI is used for diagnosis. In essence it is a cartilage injury to the surface of the heel bone, usually beneath the outer ankle. Frequently the bone beneath the surface of the joint is cracked.

• Diagnosis
  It must be considered if ankle pain is persistent, particularly if an injury appears in the case history. X-ray may show the talus being pressed in, but MRI provides the true evidence.
• Treatment
  Dependent on the extent of the injury and complaints. In acute cases a plaster cast.
• Surgical treatment
  The operation removes the damaged cartilage, then the bone below is drilled to enable new cartilage to form on the bone. Surgical intervention may be considered in cases that do not respond to conservative treatment.
• Treatment by orthotic insole
  Stability rather than correction is the main aim. The talus is supported as it is important to support the heel against pronation.