Diagnosis is usually by plain films of the foot and ankle.  The true sensitivity of plain films for these fractures is unknown, but it is accepted that some subtle fractures are not apparent on plain films.  CT or MRI are sometimes necessary to make the diagnosis.

     Care should be taken to differentiate talar avulsions from accessory ossicles (most commonly the os trigonum just posterior to the talus--see additional images for two examples), which are normal anatomic variants.