Quantitative assessment of the subchondral vascularity of the talar dome: A cadaveric study

Reply

“…They stated that the anti-CD20 antibody rituximab could mediate B cell killing by inducing antibody-dependent cell-mediated cytotoxicity, in particular via FcgRIIIa expressed on natural killer (NK) cells. Despite the fact that no significant associations between rituximab-induced remission and FcgR SNPs were identified, the findings in their study confirmed a previously described association of FcgR SNPs and clinical disease course in granulomatosis with polyangiitis (Wegener's) (GPA), namely, a favorable course among patients with combined FcgRIIa 519AA and FcgRIIIa 559GG (1,2). This indirectly implicates a pathogenic role of FcgRs in GPA.…”

“…While there are more than 20 reports of tophaceous fractures in non-weight-bearing bones, this is only the second reported case of tophus causing talus fracture. This may indicate tophaceous compromise of the distal-to-proximal blood supply of the talus leading to cortical destabilization (1,2). This case is not intended to confirm or refute a recent dual-energy CT study of gouty erosions, which found that no urate was deposited in the bone, but only on the surface in cortical defects of erosions (3).…”

Clinical Images: Gouty Tophus as an Unusual Cause of Talus Fracture

“…While there are more than 20 reports of tophaceous fractures in non–weight‐bearing bones, this is only the second reported case of tophus causing talus fracture. This may indicate tophaceous compromise of the distal‐to‐proximal blood supply of the talus leading to cortical destabilization . This case is not intended to confirm or refute a recent dual‐energy CT study of gouty erosions, which found that no urate was deposited in the bone, but only on the surface in cortical defects of erosions .…”

“…This may indicate tophaceous compromise of the distal-to-proximal blood supply of the talus leading to cortical destabilization (1,2). He had been prescribed allopurinol 8 years previously (without prophylaxis), but later experienced a severe polyarticular flare requiring hospitalization and was subsequently lost to follow-up.…”

Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT

“…The articular surface of the talus is large and its blood supply is critical in the watershed areas [1] explaining an impaired healing process and predisposition to posttraumatic necrosis in those vulnerable areas.…”