Medical Analysis Report

1. Imaging Findings

In the lateral and anteroposterior X-ray views of the patient’s right ankle joint, the talus is clearly divided into two parts by a distinct radiolucent line, forming a “separated” structure. The edges of this radiolucent line appear regular and clearly defined, which differs from the fissure usually observed in an acute fracture. No obvious cortical disruption or fracture line is seen. There is no obvious bone sclerosis or severe bone destruction around the ankle joint, and the joint space remains generally well-preserved. Soft tissue swelling is not significant.

2. Potential Diagnoses

• Talus Partitus (Talus Segmentation Variant):
  Radiographically, this presentation shows the talus divided into two or more “segments” by one or more clearly defined radiolucent lines, with regular margins and no significant callus formation or fracture line. It is often a congenital or developmental variant that may become symptomatic in adulthood due to overuse or postural issues.
• Talus Fracture:
  If the cause is traumatic, a fracture typically shows a distinct cortical break, disruption of trabecular patterns, or displacement, accompanied by significant local pain and swelling. The radiolucent line noted here is regular with smooth boundaries and no evident displacement or callus formation, making an acute fracture less likely.
• Osteochondral Injury or Osteochondral Lesion of the Talus:
  If localized sclerosis, cystic change, or fragmentation were noted near the subchondral bone or articular surface, osteochondral injury would be suspected. However, in this case, the separation line appears complete and well-defined, and no significant subchondral sclerosis or cystic changes are seen.

3. Final Diagnosis

Taking into account the patient’s 12-month history of ankle discomfort, the segmented morphology of the talus on X-ray, the regular edges, and the absence of obvious signs of fracture, the most likely diagnosis is Talus Partitus (Talus Segmentation Variant). Although this variant is congenital or developmental in nature, it may be associated with chronic ankle discomfort.

4. Treatment Plan and Rehabilitation

Based on the current situation, the main treatment strategies include:

• Conservative Treatment:
  For mild to moderate symptoms, rest and avoidance of excessive weight-bearing are recommended. An ankle brace or support may be used to stabilize the joint. Non-steroidal anti-inflammatory drugs (NSAIDs) can be administered when necessary to manage pain and inflammation.
• Physical Therapy and Rehabilitation:
  Once pain is under control, targeted physical therapy can help enhance ankle stability and improve range of motion. This may include proprioceptive training, muscle-strengthening exercises, and joint mobilization techniques. Gradual loading of the joint can be introduced as symptoms improve.
• Surgical Considerations:
  Surgery is rarely indicated. Only in cases where the condition causes severe functional impairment or recurrent pain that fails to respond to conservative treatment should surgical intervention be considered. Given that Talus Partitus is typically a benign variant, surgery is undertaken with caution.

Rehabilitation/Exercise Prescription Advice (FITT-VP Principle):

• Frequency (F): 3–4 times per week, adjusted according to symptom relief and individual fitness levels.
• Intensity (I): Low to moderate intensity. Initially, focus on non-weight-bearing or minimal weight-bearing exercises (e.g., ankle stability exercises with resistance bands). As pain subsides and ankle stability improves, gradually increase weight-bearing and difficulty.
• Time (T): About 20–30 minutes per session, which can be divided into 2–3 sets of 10 minutes each. The duration may be extended based on subjective and objective tolerance.
• Type (T): Emphasize strengthening the muscles around the ankle and improving proprioception, such as standing on tiptoe, balance pad exercises, and inversion/eversion resistance exercises with a band.
• Progression (P): Reassess every 1–2 weeks based on the patient’s pain level and functional improvement. If tolerated, gradually increase training intensity (e.g., use heavier resistance bands or introduce short-range jogging).
• Volume & Individualization (P): If pain worsens or if swelling occurs, promptly adjust the training volume and allow sufficient rest. Seek specialist consultation if necessary.

A special reminder: If there are abnormalities in foot alignment or risk of cartilage or ligament injury, an individualized rehabilitation and exercise plan should be formulated under the guidance of a professional physician and rehabilitation therapist to ensure safety.

Disclaimer: This report is based on the current medical information and imaging findings, and is provided for reference only. It is not a substitute for in-person consultation or professional medical diagnosis and treatment. If you have any questions or if symptoms worsen, please seek medical attention or consult a specialist promptly.