12:91-2. The intercondylar "notch" viewis very helpful. [Medline]. Am J Sports Med. Sports Med Arthrosc Rev. Lindholm TS, Osterman K, Vankka E. Osteochondritis dissecans of elbow, ankle and hip: a comparison survey. 2014 Jul-Sep. 2 (3):115-23. 1):561-6. Only 56% of the available MR reports assigned a label of stable or unstable to the lesion description. 1986 Aug. (209):49-56. Viegas SF. Itsubo T, Murakami N, Uemura K, Nakamura K, Hayashi M, Uchiyama S, Kato H. Am J Sports Med. Mortise view of the ankle reveals lucency in the central portion of the tibial plafond (arrowhead). [Medline]. The advantage of ultrasound is dynamic scanning with motion of the evaluated joint. It is felt that the osteochondritis dissecans can be explained on the basis of the history of trauma, which was slight but repeated in character. J Am Acad Orthop Surg. Coronal T1-weighted image 2 weeks after injury is unremarkable. 33 (2):221-50. Radiographic findings can be subtle and, in some patients, may mimic Mueller-Weiss syndrome or stress fracture of the tarsal navicular. 81 (6):1306-10. [Medline]. [22, 20, 23, 24, 25, 26], Scintigraphic findings are nonspecific, demonstrating a mild-to-marked increase in focal uptake in the involved bone, depending on the age of the osteochondritis dissecans. Filardo G, Andriolo L, Soler F, Berruto M, Ferrua P, Verdonk P, Rongieras F, Crawford DC. Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. A report of four cases. The Cheng arthroscopic staging of osteochondral lesions of the talus is as follows Clin Orthop. Satake H, Takahara M, Harada M, Maruyama M. Preoperative imaging criteria for unstable osteochondritis dissecans of the capitellum. Bernard D Coombs, MB, ChB, PhD Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New ZealandDisclosure: Nothing to disclose. 1993-4. 41(A):988-1020. 2016 Feb 18. Injury of the articular cartilage allows an influx of synovial fluid into the epiphysis, creating a subchondral cyst (see the images below). [4, 5, 6, 7, 8, 9] Plain radiographs are limited in the ability to determine the stability of OCD lesions. 8 Kijowski R, De Smet A. MRI Findings of Osteochondritis Dissecans â¦ [Medline]. A preliminary report. Osteochondritis dissecans (OCD) can affect both adults and children, however the imaging characteristics and significance of imaging findings can differ in the juvenile subset with open physes. 2020 Aug;12(4):284-293. doi: 10.1177/1758573218821151. [Medline]. J Am Acad Orthop Surg. Osteochondritis dissecans is an aseptic necrosis of subchondral bone and the overlying cartilage. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Correlation of magnetic resonance imaging to arthroscopic findings of stability in juvenile osteochondritis dissecans. Osteochondrosis of the humeral capitellum. Potential locations are the lateral aspect of the medial femoral condyle (75%), the weight-bearing surface of the medial (10%) and lateral femoral condyles (10%), and the anterior intercondylar groove or patella (5%). Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Clin Orthop. Joints. Pill SG, Ganley TJ, Milam RA, Lou JE, Meyer JS, Flynn JM. 2014 Aug;42(8):1972-7. doi: 10.1177/0363546514532604. Eur J Radiol. 163(1):38-44. Wood D, Carter KR. Paper presented at: Annual Meeting of the Academy of Orthopaedic Surgeons;. This trauma was produced by the action of the head of the â¦ Skeletal Radiol. Unstable osteochondritis dissecans â¦ 38 (5):e296-e299. J Pediatr Orthop. As the process progresses, more pronounced contour abnormalities, fragmentation and density changes (both lucency and sclerosis) become evident. Clin Orthop. [Guideline] Chambers HG, Shea KG, Anderson AF, et al. MRI provides a more precise evaluation of the size of the lesion and structure of the overlying cartilage. Mahirogullari M, Chloros GD, Wiesler ER, Ferguson C, Poehling GG. Radiology. J Bone Joint Surg [Br]. Radiology; 1998;5: Reprint. [Medline]. Osteochondritis dissecans (OCD) is a localized process that affects the subchondral bone and can progress to the overlying articular cartilage.  : Grade 1a - Bone marrow change (edema, cystic change) with no collapse of subchondral bone area and no osteochondral junction separation and intact cartilage, Grade 1b - Similar to grade 1a, although with cartilage fracture, Grade 2a - Variable collapse of subchondral bone area with osteochondral separation through intact cartilage, Grade 2b - Similar to grade 2a, although with cartilage fracture, Grade 3a - Variable collapse of subchondral bone area with no osteochondral separation with or without variable cartilage hypertrophy, Grade 3b - Similar to grade 3a, although with cartilage fracture, Grade 4a - Separation within or at edge of bone component, with intact overlying cartilage, Grade 4b - Similar to grade 4a, although with cartilage fracture; unstable lesion, with level of instability related to extent of cartilage fracture, Grade 5 - Complete detachment of osteochondral lesion; unstable lesion. [Medline]. [27, 28]. Osteochondritis dissecans (OCD) most commonly affects the knee. Axial T1-weighted image at the level of the ankle joint demonstrates abnormal low-signal intensity in the anterolateral aspect of the talus (arrowhead). 2012 Jun. Two arthroscopic classifications of osteochondral lesions of the talus are the Pritsch and Cheng surgical classifications, which are based on the appearance of the overlying articular cartilage as seen on arthroscopy. Usually a small area of bone adjacent to the articulating surface is affected. The incidence of osteochondritis dissecans in the condyles of the femur. Evaluation and treatment of osteochondritis dissecans lesions of the knee. 1986 Jul. Weiss JM, Shea KG, Jacobs JC Jr, Cannamela PC, Becker I, Portman M, et al. JB JS Open Access. Diseases & Conditions, 2001 [Medline]. . /viewarticle/940907 [Medline]. Bruns J, Werner M, Habermann C. Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint. All types of OCD were also found to have a significantly greater average BMI when compared with patients without OCD. T2-weighted sequences with fat-signal suppression are preferable over proton density-weighted sequences, because the latter are less specific for detecting fluid at the epiphyseal-bone interface. Diseases & Conditions, 2002 â¦ [Medline]. 2017 Dec 20;39(6):768-773. doi: 10.3881/j.issn.1000-503X.2017.06.006. Mosby-Year Book. [Medline]. Maruyama M, Takahara M, Satake H. Diagnosis and treatment of osteochondritis dissecans of the humeral capitellum. Perumal V, Wall E, Babekir N. Juvenile osteochondritis dissecans of the talus. A review of arthroscopic classification systems for osteochondritis dissecans of the knee. Anteroposterior radiograph of the knee is unremarkable. Sagittal T1-weighted image of the ankle confirms osteochondritis dissecans of the tarsal navicular (arrowhead). 2007 Oct. 36(10):929-35. McCullough RW, Gandsman EJ, Litchman HE. In addition, moderate obesity is associated with an increased risk of knee OCD. | A 20-year follow-up study. 1984 Sep-Oct. 12(5):351-60. 2003 Jan-Feb. 23(1):102-8. J Hand Surg [Am]. Jacobson JA. 2019 Feb 1. Arthroscopic treatment of osteochondral lesions of the talus: Long-term results. [1, 2, 3] Osteochondritis dissecans occurs in approximately 15 to 29 per 100,000 patients. Three-dimensional gradient echo sequences with various fat suppression techniques provide a detailed assessment of the cartilage and differentiate the epiphyseal cartilage from the surface cartilage by showing a thin low-signal line between the layers. Ellermann J, Johnson CP, Wang L, Macalena JA, Nelson BJ, LaPrade RF.  : Stage I - Cystic lesion of the talar dome with an intact roof, Stage IIa - Cystic lesion with communication to the talar dome surface, Stage IIb - Open articular surface lesion with an overlying, nondisplaced fragment, Stage III - Nondisplaced lesion with lucency, Stage IV - Displaced osteochondral fragment, MRI detects radiographically occult lesions that may not be detected on CT. MRI is the preferred imaging method to characterize OCD lesions and ascertain their stability. Kohyama S, Ogawa T, Mamizuka N, Hara Y, Yamazaki M. A Magnetic Resonance Imaging-Based Staging System for Osteochondritis Dissecans of the Elbow: A Validation Study Against the International Cartilage Repair Society Classification. Jungesblut OD, Berger-Groch J, Meenen NM, Stuecker R, Rupprecht M. Validity of Ultrasound Compared with Magnetic Resonance Imaging in Evaluation of Osteochondritis Dissecans of the Distal Femur in Children. 2016 Apr;24(4):1259-64. doi: 10.1007/s00167-015-3724-3. Arthroscopy. Because clinical findings are often subtle, diagnosis requires a high index of â¦ 2006 Jul. [Full Text].  It is typically found in young athletes involved in overhead-throwing sports, such as baseball, at a time when the epiphyseal growth plate is open. 2019 Apr. In the first stage (acute injury), thickened and edematous intra-articular and periarticular soft tissues are observed. Posterior longitudinal sonogram reveals an unstable lesion with a slightly displaced fragment (asterisk) and a wide gap formation (arrows; courtesy of Dr Masatoshi Takahara). [Medline]. 21(2):106-15. Joint Bone Spine. 46 (7):1592-1595. 1976 Dec. 121(3 Pt. It is hypothesized that the classification system of the International Cartilage Repair Society (ICRS) will allow for improved assessment of lesion grade and stability in OCD. Osteochondritis dissecans is the most common cause of a loose body in the joint space in adolescent patients. Rationale and objectives: | Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Background The name osteochondritis dissecans (OCD) is a misnomer. [32, 33, 34, 35, 36, 5, 10, 37, 13], T1-weighted sequences allow a detailed analysis of the bone signal. A comparison with conventional radiology and arthroscopy]. Discrepancy between morphological findings in juvenile osteochondritis dissecans (OCD): a comparison of magnetic resonance imaging (MRI) and arthroscopy. J Pediatr Orthop. An osteochondral fragment may be present in situ, incompletely â¦ 68(6):862-5. The scintigraphic appearance is probably a result of the slow repair process around an OCD, involving only the bone tissue surrounding the lesion, and is not a result of the OCD itself. Although Koenig mentioned several cases of loose bodies in the hip joint and ascribed the etiology to osteochondritis dissecans, Phemister has drawn attention to the fact that in several of these cases â¦ Acta Orthop Belg. Arthroscopic- operative treatment. Felix S Chew, MD, MBA, MEd is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North AmericaDisclosure: Nothing to disclose. Am J Sports Med. [71, 71], Satake et al found that MRI had a sensitivity of 84% for OCD, [Medline]. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Background: Evaluations of the stability of osteochondritis dissecans (OCD) lesions of the elbow using magnetic resonance imaging (MRI) have resulted in reports with variable accuracy. OCD of the tarsal navicular is limited to the proximal articular surface. 12(4):317-22. , In the ankle joint, helical CT has multiplanar capability. [46, 6], In the ankle joint, OCD occurs more frequently in the talus (see the first 9 images below) than in the tibial plafond (see the last 4 images below) and is 4-14 times more common. 2007 Feb. 28(2):154-61. 471 (4):1137-43. 2008 Aug. 248(2):571-8. 1-8. Grades 2b, 4b, and 5 are classified as unstable lesions of variable severity. Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging. 2019 Apr 17. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. 2013 Apr. 2006 Feb. 14(2):90-100. When it becomes necrotic, the â¦ Normal hard bone is covered â¦ The classification system of the ICRS, created by an international multidisciplinary, multi-expert consortium, did markedly improve the accuracy, but consistency among different readers was lacking. 1988. [Medline]. [Full Text]. J Comput Assist Tomogr. Am J Sports Med. [74, 22, 20, 23, 24, 25, 26], Kida et al reported 100% positive predictive value for ultrasound screening for OCD and suggested that a distinctive loss of the smooth articular surface on ultrasound was a good indicator of an osteochondral lesion. Insights into the Epiphyseal Cartilage Origin and Subsequent Osseous Manifestation of Juvenile Osteochondritis Dissecans with a Modified Clinical MR Imaging Protocol: A Pilot Study. Griffith MRI classification of osteochondral lesions of the talus, showing the grade description of osteochondral lesions, is as follows [Medline]. MRI findings of osteochondritis dissecans of the capitellum with surgical correlation. 1981 Jul. Diagnostic ultrasound in sports medicine: current concepts and advances. 2017 Mar. Novel radiographic feature classification of knee osteochondritis dissecans: a multicenter reliability study. J Orthop Sci. Ferkel RD, Sgaglione NA. Ellermann JM, Ludwig KD, Nissi MJ, Johnson CP, Strupp JP, Wang L, Zbýň Š, Tóth F, Arendt E, Tompkins M, Shea K, Carlson CS. [Medline]. The patella is a less common site for osteochondritis dissecans (OCD) of the knee. Arthroscopic treatment of osteochondritis dissecans of the scaphoid. Cheng MS, Ferkel RD, Applegate GR. Am J Sports Med.  Singer and Roy proposed that repeated valgus stress and a tenuous blood supply within the capitellum explain the frequent occurrence of OCD in this location. Osteochondritis Dissecans. Anteroposterior radiograph of the knee reveals osteochondritis dissecans in the lateral aspect (arrowhead) of the medial femoral condyle. Copyright © 2016. Journal Article, 2002 [Full Text]. Diseases & Conditions, encoded search term (Osteochondritis Dissecans Imaging) and Osteochondritis Dissecans Imaging, Humeral Capitellum Osteochondritis Dissecans, Cartilage Injury in the Knee: Assessment and Treatment Options, Management of Articular Cartilage Defects in the Glenohumeral Joint, Proposed RA Guidelines: Maximize Methotrexate Before Switching, Gout Clinical Practice Guidelines (ACR, 2020), A Man With Stooped Posture and Mysterious Back and Neck Pain, Denosumab Favored Over Alendronate for BMD Protection in Glucocorticoid-Induced Osteoporosis, Treatment Sequence With Romosozumab Influences Osteoporosis Outcomes.
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