Radiology; 1998;5: Reprint. J Bone Joint Surg Am 1996;78:439-56. [ 7 ], who correlated MR imaging with arthroscopic appearance. We studied the value of MR imaging in determining the stability of the osteochondral fragments. Within the risk factors, repetitive trauma is accepted [1, 3]. Upper: tangential view. 4.1 (a)–(c) Select sagittal, coronal, and axial T2 images from a 3-T MRI of the right knee without contrast. Red arrow: lesion boundary Fig. This condition occurs when a piece of the bone partially or fully separates from the end of the bone that forms a joint. Osteochondritis dissecans (OCD) of the elbow is localised most commonly at the capitellum. 3 A systematic method … Osteochondritis dissecans: History, pathophysiology and current treatment concepts. Osteochondritis Dissecans and Avascular Necrosis Matthew T. Burrus David R. Diduch DEFINITION Osteochondritis dissecans (OCD), avascular necrosis (AVN), spontaneous osteonecrosis of the knee, and chondral and osteochondral lesions all occur at or beneath the articular surface of a weight-bearing joint and are easily confused (FIG 1). Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Clanton TO, DeLee JC. One lesion that was not observed on X-ray was also The case on the left is unstable for two reasons: - small cysts at the base of the lesion (red arrow) - even more … 0 . Fig. Figure 2. A 14-year-old girl presented with gradual onset of activity-related left anterior knee pain of 1 year’s duration that had been worsening over the past 3 months. Sonographic assessment of osteochondritis dissecans of the humeral capitellum. A contained grade IV lesion measuring approximately 8 mm involving the lateral femoral condyle. She has no history of acute injury, and she reported no episodes of instability, giving-way, or locking of the knee. Osteochondritis dissecans: analysis of mechanical stability with radiography, scintigraphy, and MR imaging. Osteochondritis dissecans affects joints, most frequently the knee, in children and adolescents. Osteochondritis dissecans. Results: Agreement between MRI and arthroscopic grading was 62.1%. Osteochondritis dissecans (OCD) of the elbow is a condition of the subchondral bone and overlying cartilage, mostly affecting a part of the humeral capitellum. Upper: the elbow at AP 45° of flexion (tangential view). 2 . Author information: (1)1 All authors: Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115. J Bone Joint Surg Br 2002;84:258-62. No single treatment works for everybody. Sagittal proton density-weighted image (a), coronal T2-weighted image with fat saturation (b), and arthroscopic images (c) and (d) are shown. Over 80% of the lesions were correctly staged according to the modified grading criteria described by Berndt and Harty that were established for grading osteochondritis dissecans on conventional radiographs 22. Osteochondritis dissecans (OCD) OCD represents a chronic “overload” injury of the epiphysis. 4. The Incidence of Surgery in Osteochondritis Dissecans in … 0 . Lower: the elbow in oblique view at 45°. 7 Iyer R, Thapa M, Khanna P, Chew F. Pediatric Bone Imaging: Imaging Elbow Trauma in Children-A Review of Acute and Chronic Injuries. With the advent of MRI, this grading system was further revised including evaluation of structures invisible on conventional radiology, such as the integrity of the cartilage and presence of BME. A comparison of MRI and arthroscopic finding. 1 . Radiology 1987; 165:775. Yellow arrow: lesion. Purpose of review Juvenile osteochondritis dissecans (JOCD) knee lesions are common abnormalities in adolescents and children, and have higher rates of spontaneous healing with nonoperative management compared to adult osteochondritis dissecans (OCD) lesions. Fig. 27.2 Osteochondritis dissecans discovered after throwing-related pain is reported. Schenck RC Jr, Goodnight JM. OCD lesions occur when a segment of subchondral bone… Methods: MRI analysis of 122 knees and 132 JOCD lesions in 109 patients who underwent arthroscopic treatment for osteo-chondritis dissecans lesions of the knee between March 2003 and January 2011. 5. 27.1 Osteochondritis dissecans during the initial asymptomatic phase. 6 De Smet A. Radiology of Osteochondritis Dissecans. Mesgarzadeh M, Sapega AA, Bonakdarpour A, et al. See More See Less. In children whose bones are still growing, the bone defect may heal with a period of rest and protection. Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Lower: oblique view. Osteochondritis dissecans (OCD) of the capitellum is a localized disorder of the subchondral bone, in a region with limited healing capacity. keywords = "Grading scales, Knee, Magnetic resonance imaging, Osteochondritis dissecans", author = "Ellermann, {Jutta M.} and Bryan Donald and Sara Rohr and Takashi Takahashi and Marc Tompkins and Bradley Nelson and Amanda Crawford and Christopher Rud and Jeffrey Macalena", It can also affect other joints, such as elbows and ankles. A completely detached fragment is a loose body. Osteochondritis Dissecans. Clinical management of these lesions is based on whether or not the fragments are attached. Osteochondritis dissecans of the knee in children. A modified grading system has been proposed by Hepple in 1999 [ 5 ] and by Dipaola et al. 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