Pritsch M, Horoshovski H, Farine I. Arthroscopic treatment of osteochondral lesions of the talus. 282 (3):798-806. Accuracy was 53% when reports addressed stability. MRI correlates best with surgical staging. 2002 Adv Orthop. [Medline]. An osteochondral fragment may be present in situ, incompletely … [Medline]. J Pediatr Orthop. Ultrasonography has been used to evaluate osteochondritis dissecans of the knee and humeral capitellum (see the images below). Clin Orthop. The sonographic appearance of OCD of the capitellum is as follows: stable—localized, subchondral bony flattening and normal articular surface; stable—lesion with nondisplaced osteochondral fragment; unstable—capitellar osteochondral defect with loose intra-articular fragment; unstable—lesion with slightly displaced osteochondral fragment. 1976 Dec. 47(6):668-71. [16, 39, 46, 69, 70, 17, 18, 15, 19, 20, 21], T1-weighted sequences allow a detailed analysis of the bone signal. OCD of the tarsal navicular is limited to the proximal articular surface. Share cases and questions with Physicians on Medscape consult. [Medline]. Pill SG, Ganley TJ, Milam RA, Lou JE, Meyer JS, Flynn JM. A joint is where two bones come together. [75], 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. 1994. The purpose of this study was to investigate the performance of MRI criteria for predicting instability of osteochondritis dissecans (OCD) lesions of the elbow in children. Physical examination in the early stages does only show pain as symptom, in later stages there could be an effusion, tenderness, and a crackling sound with joint movement. Itsubo T, Murakami N, Uemura K, Nakamura K, Hayashi M, Uchiyama S, et al. Of these, 58% of the lesions were deemed unstable and 42% were stable. Satake et al found that MRI had a sensitivity of 84% for OCD,  |  OCD of the glenoid is best detected on MRI. [The staging of osteochondritis dissecans in the knee and ankle joints with MR tomography. Wall EJ, Polousky JD, Shea KG, Carey JL, Ganley TJ, Grimm NL, et al. Perhaps, the only potential differential diagnosis is a dorsal defect of the patella, which occur in the … National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. [49], Sagittal T2-weighted image of the right shoulder reveals a central depression within the glenoid (arrowhead) without associated subchondral bone marrow edema. 1975 Jun. 2015 Jan;46(1):133-9. doi: 10.1016/j.ocl.2014.09.009. 2016. This is a normal variant. Bauer M, Jonsson K, Linden B. Osteochondritis dissecans of the ankle. 7 (2):102-8. During the physical exam, your doctor will press on the affected joint, checking for areas of swelling or tenderness. [Medline]. Although it can occur from childhood through adult life, the majority of patients are 10 to 20 years of … Prevalence and Clinical Characteristics of Osteochondritis Dissecans of the Humeral Capitellum Among Adolescent Baseball Players. [Medline]. Anteroposterior radiograph of the leg reveals osteochondritis dissecans in the medial talar dome (arrowhead). Developmental defect of the glenoid is a small focal defect within the center of the glenoid and without associated subchondral bone marrow edema. Knee Surg Sports Traumatol Arthrosc. [59, 22, 60, 61]. [71, 71], Satake et al found that MRI had a sensitivity of 84% for OCD, [Full Text]. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Plain radiographs should be the first step in the evaluation of knee pain, however, unless advanced changes are present and/or a meticulous technique employed, early findings of osteochondritis dissecans may be occult. The advantage of ultrasound is dynamic scanning with motion of the evaluated joint. On conventional radiographs, osteochondral lesions may appear normal. Classification and assessment of juvenile osteochondritis dissecans knee lesions. 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. If you log out, you will be required to enter your username and password the next time you visit. Jacobson JA. [Medline]. 2019 Nov. 213 (5):1145-1151. Coronal CT of the ankle demonstrates a nondisplaced osteochondral fragment. The cause of this lesion remains elusive. Osteochondritis dissecans is an aseptic necrosis of subchondral bone and the overlying cartilage. This site needs JavaScript to work properly. Osteochondritis dissecans complicating Legg-Perthes disease. Usually a small area of bone adjacent to the articulating surface is affected. [Medline]. Viegas SF. [Medline]. Harada M, Takahara M, Sasaki J, Mura N, Ito T, Ogino T. Using sonography for the early detection of elbow injuries among young baseball players. Bare area of the glenoid: magnetic resonance appearance with arthroscopic correlation. 2018 Mar. 1995 Jul. Mohr B, Taylor RG, Baldea JD. Osteochondritis dissecans, a term which was first used by Koenig , is a limited lesion of subchondral bone necrosis, which progresses slowly towards separation of necrotic … [Medline]. [Medline]. 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. 33 (2):221-50. [Medline]. OCD of the wrist joint is rare and primarily occurs in the scaphoid. This retrospective study on OCD reporting and classification highlights the inadequacy of existing classification schemes, and emphasizes the critical need for improved diagnostic MRI protocols in musculoskeletal radiology in order to propel it toward evidence-based medicine. American Academy of Orthopaedic Surgeons clinical practice guideline on: the diagnosis and treatment of osteochondritis dissecans. Published by Elsevier Inc. NLM … 1976 Dec. 121(3 Pt. [Medline]. [39, 40, 8, 14, 41, 42, 24], The causes of OCD of the elbow are regarded as multifactorial; they include repetitive valgus stress applied to the poorly vascularized capitellum, vascular inflammation, and genetic factors. OCD of the scaphoid has been observed in bakers, boxers, pelota players, acrobats, and pneumatic drill workers, all of whom are subjected to repeated minor trauma of the wrist. 15(3):313-6. Radiol Clin North Am. 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. 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. 2014 Jan-Mar. 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. 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 … Copyright © 2016. Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. Kessler JI, Jacobs JC Jr, Cannamela PC, Shea KG, Weiss JM. [29, 30] The pathology of OCD may be described in 3 stages. New Orleans, LA. 1995 Sep-Oct. 23(5):697-704. Epub 2018 Dec 6. 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. Churchill RW, Munoz J, Ahmad CS. 1995 May-Jun. The authors concluded from their findings that previously described MR imaging criteria for OCD instability have high specificity for adult but not juvenile lesions of the knee. Diseases & Conditions, 2001 Coronal T1-weighted image of the knee demonstrates subchondral bone marrow edema (arrowhead) in the medial tibial plateau. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Anteroposterior radiograph of the knee 1 year after injury reveals an anterior cruciate ligament reconstruction (arrowheads) and lucency (arrow) in the lateral tibial plateau. 2002 Mar. 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. 2018 May. 1981 Jul. A report of two cases. Debeer P, Brys P. Osteochondritis dissecans of the humeral head: clinical and radiological findings. 1):561-6. [12], In the hip joint, OCD occurs overwhelmingly in the femoral capital epiphysis. Therefore, the … Javier Beltran, MD Chair, Department of Radiology, Maimonides Medical CenterDisclosure: Nothing to disclose. 21(2):106-15. Guelpa G, Chamay A, Lagier R. Bilateral osteochondritis dissecans of the carpal scaphoid. OCD is limited to the articular epiphysis. OCD is observed in approximately 3% of adults who had Legg-Calvé-Perthes disease as children. Role of magnetic resonance imaging and clinical criteria in predicting successful nonoperative treatment of osteochondritis dissecans in children. Epub 2019 Jan 16. 2007 Feb. 28(2):154-61. Schenck RC Jr, Athanasiou KA, Constantinides G. A biomechanical analysis of articular cartilage of the human elbow and a potential relationship to osteochondritis dissecans. Acta Orthop Scand. Most of the patients are 10-20 years of age, with males affected about twice as often as females and a higher incidence occurring in young athletes. Comparison of sonography and MRI in the evaluation of stability of capitellar osteochondritis dissecans. Ultrasonography of osteochondritis dissecans of the knee. Bachmann G, Jurgensen I, Siaplaouras J. Osteochondrosis dissecans. To diagnose osteochondritis dissecans, your orthopaedic specialist may request X-rays and an MRI … J Hand Surg [Am]. High-resolution MR imaging of talar osteochondral lesions with new classification. [Update: Clinical imaging of cartilage-part 2 : Aspects helpul in daily clinical practice]. USA.gov. [Medline]. Int Orthop. Arthroscopy. [Medline]. Roßbach BP, Paulus AC, Niethammer TR, Wegener V, Gülecyüz MF, Jansson V, Müller PE, Utzschneider S. Knee Surg Sports Traumatol Arthrosc. 2017 Mar. [15, 16, 17, 18, 19, 20, 21], Ultrasonography has been used to evaluate osteochondritis dissecans of the knee and humeral capitellum. J Bone Joint Surg [Am]. Pathology Location The condition occurs bilaterally in 25% of cases, … 2007 Oct-Nov. 27(7):821-5. To our surprise, the analysis of the existing radiology reports that addressed stability revealed an overall accuracy in defining OCD lesion stability of about 53%. Diseases & Conditions, 2002 [Full Text]. JB JS Open Access. 7 Iyer R, Thapa M, Khanna P, Chew F. Pediatric Bone Imaging: Imaging Elbow Trauma in Children-A Review of Acute and Chronic Injuries. AJR Am J Roentgenol. Axial CT of the ankle reveals osteochondritis dissecans in the posteromedial aspect of the talar dome. [Full Text]. A developmental defect of the glenoid is a normal variant that may be mistaken for OCD of the glenoid (see the first 2 images below). Juvenile versus adult osteochondritis dissecans … Magnetic Resonance Imaging of Osteochondritis Dissecans: Validation Study for the ICRS Classification System In this paper, we utilize arthroscopy as the gold standard to determine if MRI can predict OCD … 34(5):266-71. van Bergen CJ, van den Ende KI, Ten Brinke B, Eygendaal D. Osteochondritis dissecans of the capitellum in adolescents. The Berndt and Harty radiographic classification of osteochondral lesions of the talus is as follows 8(1):132-7. [45] Disparity in the mechanical properties of the central radial head and lateral capitellum probably is a factor in the initiation and localization of OCD of the capitellum (see the images below). MRI findings of osteochondritis dissecans of the capitellum with surgical correlation. Drawing of osteochondritis dissecans of the capitellum with a nondisplaced osteochondral fragment. Only case reports exist of patients with OCD of the acetabulum. Magnetic Resonance Imaging Staging to Evaluate the Stability of Capitellar Osteochondritis Dissecans Lesions. J Hand Surg [Am]. Clin Orthop. OCD of the glenoid is usually a much larger and eccentrically located lesion (see the last 4 images below). 4(4):278-81. Orthop Trans. [13]. The incidence of osteochondritis dissecans in the condyles of the femur. Griffith MRI classification of osteochondral lesions of the talus, showing the grade description of osteochondral lesions, is as follows Choi YS, Cohen NA, Potter HG, Mintz DN. AAOS Clinical Practice Guideline: diagnosis and treatment of osteochondritis dissecans. Extreme obesity has also been strongly associated with an increased risk of OCD overall and OCD of the elbow and ankle specifically. [Medline]. Kijowski R, Blankenbaker DG, Shinki K, et al. 2018 Nov. 27 (11):2038-2044. 19 (5):307-9. Lateral view of the ankle reveals a linear calcified loose body (arrowhead). [Medline]. Felix S Chew, MD, MBA, MEd Professor, Department of Radiology, Vice Chairman for Academic Innovation, Section Head of Musculoskeletal Radiology, University of Washington School of Medicine 1988. Nguyen JC, Degnan AJ, Barrera CA, Hee TP, Ganley TJ, Kijowski R. Osteochondritis Dissecans of the Elbow in Children: MRI Findings of Instability. , 4b, and geode of 17 cases arthroscopic images were evaluated by two orthopedic in... Bach BR Jr CT or MRI sustained results in osteochondritis dissecans radiology healing 2016 Feb ; 28 ( 1:133-9.... 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