Imaging Case of the Week 189 Answer

The ankle x-ray shows a lateral talar dome fracture. There is also significant soft tissue swelling over the medial malleolus.

talar dome fracture

Talar dome fracture CT

This is a missable fracture.

Fractures of the lateral talar dome usually occur due to trauma, whereas medial talar dome fractures are caused by repetitive stress and may be chronic.

Treatment involves a below knee cast, non-weight bearing crutches, and a referral to an orthopaedician. Displaced talar dome fractures will need operative management.

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