Pediatric Ankle trauma feedback

Dear Colleagues,Thank you for your great input in the ankle trauma case.
Below are the feedbacks that I’ve received

Aveesh: post traumatic avn- colllapse- mechanical synovitis

Nicholas: It’s AVN. JIA wouldn’t affect the talus so extensively without also involving the tibia.

Cyrus: I would tap the joint ASAP. Can’t r/u JIA or septic arthritis with osteo.

JOEL RUBENSTEIN:

My main consideration is large osteochondral defect with partial collapse; vertical fracture line seen posteriorly.

I don’t see serpiginous double line to suggest AVN

Susie Muir: I would agree with AVN. He wasn’t treated for the talar fracture at all?

Hamza: This is a nice case as well. Any clinical concern for infection? I would consider aspirating to be sure. Are there predisposing factors for AVN besides trauma? Would be interesting to see initial X-rays.

BW,
Talaat

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