What Is a Talar Dome Lesion?

Signs and Symptoms of a Talar Dome Lesion

Unless the injury is extensive, it may take months, a year, or even longer for symptoms to develop. The signs and symptoms of a talar dome lesion may include:

Chronic pain deep in the ankle—typically worse when bearing weight on the foot (especially during sports) and less when resting

An occasional “clicking” or “catching” feeling in the ankle when walking

A sensation of the ankle “locking” or “giving out”

Episodes of swelling of the ankle—occurring when bearing weight and subsiding when at rest

How a Talar Dome Lesion Is Diagnosed

A talar dome lesion can be difficult to diagnose because the precise site of the pain can be hard to pinpoint. To diagnose this injury, the foot and ankle surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking, or limitation of motion within that joint. Sometimes the surgeon will inject the joint with an anesthetic (pain-relieving medication) to see if the pain goes away for a while, indicating that the pain is coming from inside the joint. X-rays are taken, and often an MRI or other advanced imaging tests are ordered to further evaluate the lesion and extent of the injury.

Treatment: Non-Surgical Approaches

Treatment depends on the severity of the talar dome lesion. If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following non-surgical treatment options may be considered:

Immobilization. Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. During this period of immobilization, non-weight bearing range-of-motion exercises may be recommended.
Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing pain and inflammation.
Physical therapy. Range-of-motion and strengthening exercises are beneficial once the lesion is adequately healed. Physical therapy may also include techniques to reduce pain and swelling.
Ankle brace. Wearing an ankle brace may help protect the patient from re-injury if the ankle is unstable.

When Is Surgery Needed?

If non-surgical treatment fails to relieve the symptoms of talar dome lesions, surgery may be necessary. Surgery may involve the removal of loose bone and cartilage fragments within the joint and the establishment of an environment for healing. A variety of surgical techniques are available to accomplish this. The surgeon will select the best procedure based on the specific case.

Complications of Talar Dome Lesions

Depending on the amount of damage to the cartilage in the ankle joint, arthritis may develop in the joint, resulting in chronic pain, swelling, and limited joint motion. Treatment for these complications is best directed by a foot and ankle surgeon and may include one or more of the following

Non-steroidal or steroidal anti-inflammatory medications
Physical therapy
Bracing
Surgical intervention

Our board-certified foot and ankle surgeons will assess your condition and develop the best treatment plan for you.

Looking for Minimally Invasive Surgery options in Annapolis, Stevensville, or Glen Burnie, Maryland?

Our Annapolis podiatrists are experts in minimally invasive surgery. Our podiatric surgeons will work with you to find the best treatment option for your pain or injury.

Whether you see us in our office in Annapolis, Stevensville, or Glen Burnie, you will have access to our full range of state-of-the-art treatments and therapies. We service all of Central Maryland and look forward to helping you. Contact us online or call us directly to schedule an appointment with one of our experienced podiatrists.