Osteochondritis dissecans, unspecified ankle and joints of foot. M93. 279 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
2022 ICD-10-CM Diagnosis Code S92. 14: Dome fracture of talus.
A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage.
An osteochondral lesion of the talus occurs when an ankle sprain or injury damages the cartilage and the bottom bone of the ankle joint, known as the talus. Osteochondral lesions of the talus can be challenging to diagnose because they are often masked by swelling and inflammation from the original injury.
Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage.
It is the highest bone of the foot, located just below the point where the lower leg unites with the foot. The Talar Dome refers to the upper rounded part of the talus that joins upward with the bones of the lower leg tibia and fibula to form the ankle joint.May 27, 2018
The common treatment strategies of symptomatic osteochondral lesions include nonsurgical treatment, with rest, cast immobilisation and use of nonsteroidal anti-inflammatory drugs (NSAIDs).
The talus is a small bone that sits between the heel bone (calcaneus) and the two bones of the lower leg (the tibia and fibula). It has an irregular, humped shape like a turtle's shell. The bones of the lower leg ride on top and around the sides to form the ankle joint.
Most osteochondral talar defects are caused by trauma. They may heal and remain asymptomatic or progress to subchondral cysts with deep ankle pain on weight bearing.
An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. The defects cause deep ankle pain associated with weightbearing.
Osteochondral Lesions of the Talus are focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage which may be caused by a traumatic event or repetitive microtrauma. Diagnosis can be made with plain ankle radiographs.
covers 70% of talus. among the thickest in the body (implications for osteochondral autografting) maintains tensile strength longer than femoral head with aging process. Blood supply. relies on extra-osseous blood supply. deltoid artery supplies majority of talar body and dome.
MRI studies are helpful in determining the size of the lesion, the extent of bony edema, and identify unstable lesions . Treatment can be nonoperative or operative depending on patient age, patient activity demands, lesion size, and stability of lesion. Epidemiology. Incidence. 69% of ankle fractures.
appropriately sized autograft may be harvested from knee and placed into OLT, impacted gently into defect. OATs harvested from the knee have a cartilage thickness less than the native talus. this will cause immediate post-operative xrays to show a prominent graft despite the cartilage surface being flush.
Articular Cartilage Defect#N#For an isolated "articular cartilage defect" the most specific code would be M94.8X _: Other Specified Disorders of Cartilage (of joint). Although this code set includes the knee (lower leg: 6) and does not appear to exclude the Patella, I think that for the Patella, M22.8 _ (Other Disorders of the Patella) would be more correct. M24.8 _: Other Specified Derangement of Joint NEC seems to me to be far less specific. This is the simplest answer to the question, but this can be only a part of the joint problem. Other concerns are the presence or absence of a Cartilaginous Loose Body (s) originating from the "defect," and/or is there other articular cartilage disease of the joint, such as Chondromalacia?#N#Chondromalacia is "softening" of the articular cartilage, with varying degrees of depth and severity of involvement. It can progress to the point of producing an articular cartilage defect all the way to the bone underneath. For all joints and areas other than the Patella, M94.2 _ _ would apply to the associated Chondromalacia, if present. For Patellar Chondromalacia, if associated with an articular cartilage defect, then M22.4 _ would apply. However, the presence of Chondromalacia in any joint or area does not necessarily mean there is an articular cartilage defect, but the two can occur simultaneously/concurrently.#N#An articular cartilage defect can also be associated with &/or the source of a Cartilaginous Loose Body in the affected joint. For the knee joint, the code for an associated Loose Body would be M23.4 _; but for other joints, it would be M24.1 _ _.#N#I would be careful about "Cartilage Derangement" as regards this problem/issue. As it applies to the knee joint, "Cartilage Derangement" applies to meniscal tears, not articular cartilage disorders.#N#I hope this is more helpful than confusing.#N#Respectfully submitted, Alan Pechacek, M.D.
However, the presence of Chondromalacia in any joint or area does not necessarily mean there is an articular cartilage defect, but the two can occur simultaneously/concurrently. An articular cartilage defect can also be associated with &/or the source of a Cartilaginous Loose Body in the affected joint.