Many classification schemes for osteochondral lesions of the talus have been proposed with the Berndt and Harty classification being the earliest and most commonly used. It is a 4-stage classification that grades the lesion based on the appearance on plain radiographs and is focused on transchondral fractures
Berndt and Harty’s classification is used for osteochondral lesions of the talus.
Classification
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Berndt and Harty Radiographic Classification
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Stage 1
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Small area of subchondral compression
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Stage 2
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Partial fragment detachment
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Stage 3
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Complete fragment detachment but not displaced
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Stage 4
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Displaced fragment
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Ferkel and Sgaglione CT Staging System
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Stage 1
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Cystic lesion within the dome of the talus with an intact roof on all view
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Stage 2a
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Cystic lesion communication to the talar dome surface
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Stage 2b
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Open articular surface lesion with the overlying nondisplaced fragment
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Stage 3
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A nondisplaced lesion with lucency
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Stage 4
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Displaced fragment
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Hepple MRI Staging System
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Stage 1
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Articular cartilage edema
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Stage 2a
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Cartilage injury with underlying fracture and surrounding bony edema
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Stage 2b
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Stage 2a without surrounding bone edema
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Stage 3
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Detached but nondisplaced fragment
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Stage 4
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Displaced fragment
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Stage 5
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Subchondral cyst formation
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Classification
- stage I: subchondral bone compression (marrow edema)
- stage II
- stage IIa: subchondral cyst
- stage IIb: incomplete separation of fragment
- stage III: complete separation but no displacement
- stage IV: displaced fragment
References
