Ankle Osteochondral Lesion

General Information

  • Sometimes called osteochondritis dessicans or osteochondral fractures
  • Usually have a history of injury, single or repeated.
  • Diagnosis is one of suspicion, after ruling out other pathologies.

Symptoms and signs

  • Pain may be severe, diffuse or local and prolonged felt primarily at the lateral or medial aspect of the ankle joint
  • Swelling, catching and/or instability of the ankle joint.

Primary Care management

Analgesia and NSAIDs as appropriate

Primary Care diagnostics

XR ankle AP standing and lateral views. 

Who to refer

No improvement after 3 months (MRI or CT may be required).

How to refer

SCI Gateway/Orthopaedics/Foot & Ankle Service.
Referral will be vetted by an AHP and directed to the most appropriate healthcare professional.


Information to include when referring:
  • Duration and any cause of symptoms
  • Indicate site/spread of pain and if pain constant or intermittent, and/or waking at night
  • Indicate ROM, effect on walking, running
  • Include treatment to date (injections/ podiatry/ orthotics/ physiotherapy)
  • XR results