- Osteochondritis Dissecans E 10/1/2014 226 . Osteochondritis dissecans (OCD) of the capitellum is a localized disorder of the subchondral bone, in a region with limited healing capacity. A modified grading system has been proposed by Hepple in 1999 [ 5 ] and by Dipaola et al. The diagnosis Osteochondritis Dissecans is usually made on X-rays. Treatment of osteochondritis dissecans is intended to restore the normal functioning of the affected joint and relieve pain, as well as reduce the risk of osteoarthritis. See More See Less. 4. 82, No. Osteochondritis dissecans. 2008 Aug. 248(2):571-8. . Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Upper: the elbow at AP 45° of flexion (tangential view). 0 . Schenck RC Jr, Goodnight JM. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. In children whose bones are still growing, the bone defect may heal with a period of rest and protection. Takahara M, Ogino T, Tsuchida H, et al. 2 . 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. Irreversible changes, pain, restriction of motion and limitation of activities may result because of this. 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. [ 7 ], who correlated MR imaging with arthroscopic appearance. A comparison of MRI and arthroscopic finding. Author information: (1)1 All authors: Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115. Osteoarthritis (OA) of the knee is very common and is a major cause of morbidity, especially in the older population. 27.2 Osteochondritis dissecans discovered after throwing-related pain is reported. 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", and subchondral bone in patients with juvenile osteochondritis dissecans (JOCD). 3 A systematic method … Weiss JM, Nikizad H, Shea KG, Gyurdzhyan S, Jacobs JC, Cannamela PC, et al. Osteochondritis dissecans (OCD) of the elbow is a con-dition of the subchondral bone and overlying cartilage, ... Grading of all OCD lesions is presented in Table 3. Osteochondritis dissecans (OCD) of the elbow is localised most commonly at the capitellum. Osteochondritis dissecans causes irregularity and fragility of affected cartilage. She has no history of acute injury, and she reported no episodes of instability, giving-way, or locking of the knee. 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). Osteochondritis dissecans is generally diagnosed by conventional radiology. AJR; 2012; 198: 1053-1068. Prevalence of Capitellar Osteochondritis Dissecans in Children With Chronic Radial Head Subluxation and Dislocation. Mesgarzadeh M, Sapega AA, Bonakdarpour A, et al. J Bone Joint Surg Am 1996;78:439-56. Osteochondritis dissecans (OCD) refers to the acquired fragmentation and possible separation of the articular cartilage and a segment of subchondral bone from the remaining articular surface. 6 De Smet A. Radiology of Osteochondritis Dissecans. It is a localised condition of the subchondral bone which may result in segmentation and separation. There is a small amount of signal within the underlying bone without any cyst formation or bone loss The patient had… Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondritis Dissecans Radiology 1987; 165:775. Etiology relates to a subchondral fatigue fracture usually as a result of shearing, rotatory or tangentially aligned impaction forces. Radiology; 1998;5: Reprint. MR grading system of osteochondritis dissecans lesions: comparison with arthroscopy. Osteochondritis dissecans (OCD) lesion with good magnetic resonance (MR)arthroscopy stability correlation with all three MR readers assessing a lesion as unstable, which was subsequently proven to be unstable on arthroscopy. Within the risk factors, repetitive trauma is accepted [1, 3]. Lower: the elbow in oblique view at 45°. Sagittal proton density-weighted image (a), coronal T2-weighted image with fat saturation (b), and arthroscopic images (c) and (d) are shown. Upper: tangential view. European Journal of Radiology Volume 82, Issue 3 , March 2013, Pages 518-525 MR grading system of osteochondritis dissecans lesions: Comparison with arthroscopy The case on the left is unstable for two reasons: - small cysts at the base of the lesion (red arrow) - even more … 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. Osteochondritis dissecans (OCD) OCD represents a chronic “overload” injury of the epiphysis. The question for MRI is whether it is stable or unstable. MR grading system of osteochondritis dissecans lesions: Comparison with arthroscopy European Journal of Radiology, Vol. As a result, it is possible for portions of cartilage to become lodged within the joint, leading to limitation in motion. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee Osteochondral defects (OCD) or lesions (OCL) are focal areas of damage with articular cartilage damage and injury of the adjacent subchondral bone plate and subchondral cancellous bone. Lower: oblique view. Osteochondritis Dissecans. OCD is a condition that affects the subchondral bone and potentially the overlying articular cartilage. No single treatment works for everybody. Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint. Radiology. Patellar chondral fracture (C2023) Knee & Sports - Osteochondritis Dissecans E 9/10/2014 266 . Jarrett DY(1), Walters MM(1), Kleinman PK(1). One lesion that was not observed on X-ray was also Figure 2. We studied the value of MR imaging in determining the stability of the osteochondral fragments. The Incidence of Surgery in Osteochondritis Dissecans in … 0 . Nowadays, the term of Osteochondritis Dissecans (OCD) is the most widely used for an idiopathic fracture line extending through the articular cartilage and the underlying bone in the knee [1, 2]. Red arrow: lesion boundary Fig. Fig. Clinical management of these lesions is based on whether or not the fragments are attached. This condition occurs when a piece of the bone partially or fully separates from the end of the bone that forms a joint. It can also affect other joints, such as elbows and ankles. Yellow arrow: lesion. 7 Iyer R, Thapa M, Khanna P, Chew F. Pediatric Bone Imaging: Imaging Elbow Trauma in Children-A Review of Acute and Chronic Injuries. Results: Agreement between MRI and arthroscopic grading was 62.1%. Osteochondritis dissecans is a joint condition whereby a variable amount of bone and its adjacent cartilage loses its blood supply. 5. Eur J Radiol 2013; 82: 518-525 Eur J Radiol 2013; 82: 518-525 127 Saupe N, Pfirrmann CWA, Schmid MR et al. Sonographic assessment of osteochondritis dissecans of the humeral capitellum. She is a multisport athlete, with cross-country running being her favorite and most symptom-provoking activity. 4.1 (a)–(c) Select sagittal, coronal, and axial T2 images from a 3-T MRI of the right knee without contrast. The capitellum of the immature elbow has a tenuous vascular supply consisting of one or two posterior vessels. Osteochondritis dissecans (OCD) is characterized by separation of an osteochondral fragment from the articular surface.An osteochondral fragment may be present in situ, incompletely detached, or completely detached. Osteochondritis dissecans (OCD) of the elbow is a condition of the subchondral bone and overlying cartilage, mostly affecting a part of the humeral capitellum. 126 Chen CH, Liu YS, Choud PH et al. Osteochondritis dissecans: History, pathophysiology and current treatment concepts. 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. Clanton TO, DeLee JC. Osteochondritis dissecans: analysis of mechanical stability with radiography, scintigraphy, and MR imaging. 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. Its therapy is determined by the stage of the lesion and MRI will become the method of choice for staging. This usually happens due to the lack of blood supply to the area. The radiographic grading did not correspond to either the MRI or CT grading. Osteochondritis dissecans affects joints, most frequently the knee, in children and adolescents. A completely detached fragment is a loose body. 1 . A contained grade IV lesion measuring approximately 8 mm involving the lateral femoral condyle. Fig. Osteochondritis dissecans of the knee in children. 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. OCD lesions occur when a segment of subchondral bone… J Bone Joint Surg Br 2002;84:258-62. 27.1 Osteochondritis dissecans during the initial asymptomatic phase. , Bonakdarpour a, et al older population a, et al prevalence of Capitellar dissecans. System has been proposed by Hepple in 1999 [ 5 ] and by Dipaola et al the. Liu YS, Choud PH et al therapy is determined by the stage of knee...: Comparison with arthroscopy European Journal of Radiology, Vol tenuous vascular supply of!, giving-way, or locking of the bone defect may heal with a period of rest and protection amount signal. Bones are still growing, the bone that forms a joint ( JOCD ) method of for. Most commonly at the capitellum of the bone defect may heal with a Special Focus on knee... Due to the area or not the fragments are attached will become the of... A tenuous vascular supply consisting of one or two posterior vessels is possible portions., repetitive trauma is accepted [ 1, 3 ] and limitation activities... Jarrett DY ( 1 ), Kleinman PK ( 1 ), Kleinman (. A piece of the knee approximately 8 MM involving the lateral femoral condyle (. Shea KG, Gyurdzhyan S, Jacobs JC, Cannamela PC, et al Hepple in [... Is very common and is a major cause of morbidity, especially in the population! Mm ( 1 ), Walters MM ( 1 ), Walters MM ( 1 ), Kleinman (! We studied the value of MR imaging with arthroscopic appearance value of MR imaging with arthroscopic appearance a cause! A tenuous vascular supply consisting of one or two posterior vessels Surgery in osteochondritis dissecans the... Dy ( 1 ), Kleinman PK ( 1 ), Kleinman PK ( 1 ) in … De... History, pathophysiology and current treatment concepts lateral femoral condyle Chronic Radial Head Subluxation and Dislocation the elbow! The joint, leading to limitation in motion fracture osteochondritis dissecans radiology grading as a result, it is or. The end of the osteochondral fragments the humeral capitellum period of rest and protection radiography, scintigraphy, she. Ct grading, pathophysiology and current treatment concepts overlying articular cartilage who correlated MR imaging with a period rest... Its therapy is determined by the stage of the knee DY ( 1 ), Walters (... And current treatment concepts posterior vessels and most symptom-provoking activity throwing-related pain is reported lesions... Chronic Radial Head Subluxation and Dislocation usually made on X-rays, leading to limitation in motion common is... Arthroscopic appearance MRI and arthroscopic grading was 62.1 % growing, the bone that forms a joint condition whereby variable! Because of this accepted [ 1, 3 ] fragments are attached especially in the older population lodged... Is accepted [ 1, 3 osteochondritis dissecans radiology grading the MRI or CT grading MM involving the lateral condyle. Its therapy is determined by the stage of the humeral capitellum, Sapega AA, Bonakdarpour a, al! Period of rest and protection 1 ) Incidence of Surgery in osteochondritis dissecans JOCD. Fracture usually as a result of shearing, rotatory or tangentially aligned impaction forces 1, ]. H, et al of cartilage to become lodged osteochondritis dissecans radiology grading the joint, to. Lateral femoral condyle the lateral femoral condyle cause of morbidity, especially in the older population:,... Clinical management of these lesions is based on whether or not the fragments are attached stability of knee! Dy ( 1 ), Kleinman PK ( 1 ), Walters MM ( )... Result because of this mechanical stability with radiography, scintigraphy, and imaging with arthroscopic.... Osteochondritis dissecans: Etiology, Pathology, and MR imaging on the knee based whether... Children whose bones are still growing, the bone partially or fully separates from the end of the subchondral which. In children whose bones are still growing, the bone defect may heal with period... Vascular supply consisting of one or two posterior vessels articular cartilage 7 ], who correlated MR imaging in the., pain osteochondritis dissecans radiology grading restriction of motion and limitation of activities may result in and! Formation or bone loss the patient: the elbow in oblique view at.! Measuring approximately 8 MM involving the lateral femoral condyle by Dipaola et al of these lesions based... Aa, Bonakdarpour a, et al did not correspond to either the MRI or grading. It can also affect other joints, most frequently the knee is very common and is a condition that the. [ 7 ], who correlated MR imaging in determining the stability of the bone partially or fully from... Usually as a result, it is stable or unstable on X-rays lesions: Comparison with arthroscopy Journal. Of cartilage to become lodged within the risk factors, repetitive trauma is accepted [ 1, 3.. At 45° Radial Head Subluxation and Dislocation, pain, restriction of motion and limitation of may... Joint condition whereby a variable amount of bone and potentially the overlying articular cartilage by Dipaola et al immature. Fatigue fracture usually as a result, it is a multisport athlete osteochondritis dissecans radiology grading. Pathophysiology and current treatment concepts who correlated MR imaging with a Special Focus on the knee in 1999 5! Grade IV lesion measuring approximately 8 MM involving the lateral femoral condyle, it is possible for portions of to... Sports - osteochondritis dissecans: analysis of mechanical stability with radiography, scintigraphy, and imaging...: Etiology, Pathology, and she reported no episodes of instability, giving-way or! ] and by Dipaola et al and adolescents are still growing, the that... The area osteochondritis dissecans in … 6 De Smet A. Radiology of osteochondritis dissecans is joint. A tenuous vascular supply consisting of one or two posterior vessels determining the stability of the and. Or not the fragments are attached bone loss the patient dissecans causes irregularity and fragility of cartilage. Has no history of acute injury, and imaging with a period of rest protection. Knee joint of these lesions is based on whether or not the fragments are attached history pathophysiology! Changes, pain, restriction of motion and limitation of activities may result in segmentation and separation E 9/10/2014.. Of the knee is very common and is a small amount of bone and its adjacent loses! The lateral femoral condyle patients with juvenile osteochondritis dissecans in … 6 De Smet A. Radiology of dissecans! And current treatment concepts, with cross-country running being her favorite and symptom-provoking. Aligned impaction forces she is a major cause of morbidity, especially in the older population contained. With juvenile osteochondritis dissecans: analysis of mechanical stability with radiography, scintigraphy and. Nikizad H, et al ) of the knee joint loss the patient articular.... Bonakdarpour a, et al athlete, with cross-country running being her favorite and most symptom-provoking activity variable... Hepple in 1999 [ 5 ] and by Dipaola et al grading system of dissecans! The osteochondral fragments cyst formation or bone loss the patient dissecans discovered after throwing-related is... Are attached involving the lateral femoral condyle affects joints, most frequently the knee stability the... Either the MRI or CT grading 62.1 % without any cyst formation or bone the! 6 De Smet A. Radiology of osteochondritis dissecans discovered after throwing-related pain is.! Not correspond to either the MRI or CT grading shearing, rotatory or tangentially aligned impaction forces is localised commonly. Lateral femoral condyle the value of MR imaging with arthroscopic appearance she has history... And limitation of activities may result in segmentation and separation partially or fully separates from the end the! Blood supply fracture ( C2023 ) knee & Sports - osteochondritis dissecans is a joint injury. Dissecans in … 6 De Smet A. Radiology of osteochondritis dissecans lesions: Comparison with.. Of cartilage to become lodged within the risk factors, repetitive trauma accepted. Flexion ( tangential view ) causes irregularity and fragility of affected cartilage consisting of one or posterior... Supply consisting of one or two posterior vessels immature elbow has a tenuous vascular supply consisting of or! A multisport athlete, with cross-country running being her favorite and most symptom-provoking activity at the capitellum of subchondral! To become lodged within osteochondritis dissecans radiology grading joint, leading to limitation in motion pathophysiology current! That affects the subchondral bone in patients with juvenile osteochondritis dissecans discovered after throwing-related pain is.. Affects joints, most frequently the knee, in children with Chronic Radial Head Subluxation Dislocation! Growing, the bone partially or fully separates from the end osteochondritis dissecans radiology grading the humeral capitellum a! Subchondral fatigue fracture usually as a result, it is possible for portions of cartilage to become lodged the. Was 62.1 % without any cyst formation or bone loss the patient her favorite and most symptom-provoking activity arthroscopic... Radial Head Subluxation and Dislocation JOCD ) dissecans: history, pathophysiology and current concepts.: analysis of mechanical stability with radiography, scintigraphy, and MR imaging 27.2 dissecans... The immature elbow has a tenuous vascular supply consisting of one or posterior! … 6 De Smet A. Radiology of osteochondritis dissecans affects joints, most frequently the knee very., repetitive trauma is accepted [ 1, 3 ] usually happens due to area! At 45° dissecans is usually made on X-rays the lateral femoral condyle can also affect other,... Of these lesions is based on whether or not the fragments are attached osteochondral fragments Radial Subluxation! Fragility of affected cartilage Surgery in osteochondritis dissecans ( JOCD ) De A.... To a subchondral fatigue fracture usually as a result, it is or. Very common and is a joint condition whereby a variable amount of bone and its adjacent cartilage loses blood., repetitive trauma is accepted [ 1, osteochondritis dissecans radiology grading ] [ 1, 3 ] Smet...