What causes Hawkins Sign in the ankle on frontal radiograph?
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Answer:
Hawkins Sign is a subchondral lucent band on the talar dome visible 6-8 weeks after talar neck or talar body fracture, indicating preserved vascularity through disuse osteopenia and predicting low risk of avascular necrosis (AVN) with good prognosis.
Why is it called so?:
Named after Jack Hawkins, who described it in 1970 as subchondral talar dome osteopenia on ankle radiographs 6 weeks post-talar fracture to assess vascular integrity.
Pathophysiology:
Post-fracture immobilization causes disuse osteopenia via bone resorption in vascularized subchondral bone, manifesting as lucency beneath the talar dome; intact vascularity allows osteoclast-mediated resorption, while avascular bone remains sclerotic without lucency.
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