J Korean Foot Ankle Soc.  2019 Dec;23(4):183-188. 10.14193/jkfas.2019.23.4.183.

Improvement of Pain according to Magnetic Resonance Imaging Classification in Bone Contusion around Foot and Ankle

Affiliations
  • 1Department of Orthopedic Surgery, Chonbuk National University Medical School, Jeonju, Korea. osdr2815@naver.com
  • 2Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.

Abstract

PURPOSE
Bone contusion is usually treated with conservative therapy for 3 months. Bone contusion around knee and hip joints has been extensively reported on, but there are scant reports on this condition in foot and ankle joints. This study evaluated the nature, characteristics and location of bone contusion around foot and ankle joints to enlighten clinicians on how to better treat this disease entity.
MATERIALS AND METHODS
We classified bone contusion of the 76 patients into three types (102 sites; 47 ankle sprains, 18 traffic accidents, 11 falls) according to the Costa-Paz system with employing magnetic resonance imaging (MRI), and the study then analyzed the common sites and areas of occurrence according to the mechanism of injury and duration of pain after first conducting conservative therapy.
RESULTS
Of the 76 patients (102 sites) on the MRI, 43 case (42.2%) for talus, 19 cases for distal tibia, and 12 cases for calcaneus were involved. The classification, according to the Costa-Paz system, was Type I, 51 cases; Type II, 32 cases; and Type III, 19 cases. The duration of pain after conservative treatment was 12.15±2.17 weeks for Type I, 14.5±2.15 weeks for Type II, and 21.0±3.8 weeks for Type III.
CONCLUSION
The most common location of post-traumatic bone contusion around both the foot and ankle is the talus, distal tibia, and calcaneus. The most common type of injury noted on MRI is a diffuse signal with change of the medullary component (Type I), In cases of bone contusion extending to a subjacent articular surface or disruption or depression of the normal contour of the cortical surface (Types II, III), the patients' pain appears to last longer. Thus, it is necessary to consider a longer period of conservative treatment in cases of Types II and III bone contusion because the patients' pain may last longer than 3 months.

Keyword

Bone contusion; Magnetic resonance imaging; Foot and Ankle

MeSH Terms

Accidents, Traffic
Ankle Injuries
Ankle Joint
Ankle*
Calcaneus
Classification*
Contusions*
Depression
Foot*
Hip Joint
Humans
Knee
Magnetic Resonance Imaging*
Talus
Tibia
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