![(a) AP radiograph of the ankle obtained 8 weeks after a talar neck fracture treated with open reduction and internal fixation reveals a subchondral radiolucent band (arrowheads) in the talar dome; this band is the Hawkins sign. Osteopenia is present in the distal tibial metaphysis. (b) AP radiograph obtained in a different patient 12 weeks after a talar neck fracture treated with open reduction and internal fixation does not show the Hawkins sign. Osteopenia is present in the distal tibial metaphysis, but a subchondral radiolucent band is not seen in the talar dome. The absence of the Hawkins sign suggests a high risk of avascular necrosis.

Donnelly EF. The Hawkins sign. Radiology. 1999;210(1):195-196. doi:10.1148/radiology.210.1.r99ja08195](attachment:7eebf186-649f-4887-8596-dacedb8b1246:image.png)

(a) AP radiograph of the ankle obtained 8 weeks after a talar neck fracture treated with open reduction and internal fixation reveals a subchondral radiolucent band (arrowheads) in the talar dome; this band is the Hawkins sign. Osteopenia is present in the distal tibial metaphysis. (b) AP radiograph obtained in a different patient 12 weeks after a talar neck fracture treated with open reduction and internal fixation does not show the Hawkins sign. Osteopenia is present in the distal tibial metaphysis, but a subchondral radiolucent band is not seen in the talar dome. The absence of the Hawkins sign suggests a high risk of avascular necrosis.

Donnelly EF. The Hawkins sign. Radiology. 1999;210(1):195-196. doi:10.1148/radiology.210.1.r99ja08195