1 The first description of these lesions in the ankle was provided in 1922. Loading images... Sagittal T1 . MRI is the single best study for both the diagnosis and prognosis of the osteochondritis dissecans lesion of the talus. Care of the Young Athlete, 2nd ed, Anderson SJ, Harris SS, Gregory AJM (Eds), American Academy of Pediatrics, Elk Grove Village 2010. Osteochondritis dessicans of the talus in a 26-year-old woman. J Bone Joint Surg Am. 2008 Aug. 248(2):571-8 In 13 of 14 patients who had had correlative surgery, we accurately … Giannini S, Buda R, Grigolo B, et al. Males are typically affected twice as often as females, with a higher incidence occurring in young athletes. Case contributed by Dr Matt Skalski Diagnosis certain Diagnosis certain . [1] OCD usually causes pain and swelling of the affected joint which catches and locks during movement. Zanon G(1), DI Vico G(2), Marullo M(1). Ankle sprains are a common cause of OLTs. MRI classification of juvenile osteochondritis dissecans lesions Hefti F ... Aggarwal V, et al. [Figure caption and citation for the preceding image starts]: Coronal magnetic resonance image (MRI) of the talus showing an osteochondral lesion on the medial aspect of the talar dome Gupta RK, Kansay R, Aggarwal V, et al. Osteochondritis dissecans is an aseptic necrosis of subchondral bone and the overlying cartilage. 2 case question available. Foot Ankle 1985; 5:165. The detached osteochondral fragment AS a source of cells for autologous chondrocyte implantation (ACI) in the ankle joint. When it becomes necrotic, the overlying cartilage is devitalized, and frequently the entire fragment separates out and forms an intra-articular loose body. 7. Helping you find trustworthy answers on Osteochondritis Dissecans of Talus | Latest evidence made easy Osteochondritis dissecans of the talus. Osteochondritis dissecans has been reported to affect the ankle as the third most common joint, after the knee and the elbow.1 A 26-year-old housewife presented with chronic ankle pain for 3 weeks duration with intermittent swelling after exertion, without any history of trauma. 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. Is MRI superior to helical CT? Red arrows point to osteochondral defect and bone edema on T1 and stir MRI images of the knee in same patient as above. Although it can occur from childhood through adult life, the majority of patients are 10 to 20 years of age. ... MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study. 24, No. With this type of injury, a section of the talus surface may impact another part of the ankle joint (tibia or fibula). Radiology. Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, Vermont See all articles by this author. 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. 2012 Sep 26. . A. The value of magnetic resonance imaging in the clinical course of steochondrosis dissecans in the knee and ankle joints [in German]. BMJ Case Reports 2009; doi:10 .1136/bcr.06.2008.0091 [Citation ends]. Osteochondritis dissecans (OCD) is an acquired idiopathic lesion of subchondral bone that can produce delamination and sequestration with or without articular cartilage involvement and instability. Since 1983, 24 children have been treated for OCD of the talus at a major Canadian pediatric referral center. B. Flick . Case Discussion. Orthop J Sports Med … Occasionally other studies may be helpful such as a computed tomography (CT scan) to further define the anatomy of the lesion and occasionally a bone scan is … The majority of OLTs, as many as 85 percent, occur after a traumatic injury to the ankle joint. Features are consistent with osteochondritis dissecans of the ankle joint. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. MRI. Presentation. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. It can occur in all age groups. Osteochondritis dissecans occurs in approximately 15 to 29 per 100,000 patients. Osteochondritis dissecans (OCD) of the talus is rare in children. In 1888 Konig was the first author to use the term osteochondritis dissecans to describe loose bodies found in the knee joint; he believed them to be fragments from an avascular bone lesion . This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March 1, 2011, and May 31, … A Patient’s Guide to Osteochondritis Dissecans of the Talus Introduction. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Magnetic resonance imaging (MRI) ... Flick AB, Gould N. Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. J Bone Joint Surg 2005;87B:41–46. No single treatment works for everybody. Usually a small area of bone adjacent to the articulating surface is affected. strategies in osteochondral lesions of the talus. Even the smallest osteochondritis dissecans lesion will appear on a MRI of the ankle and talus region. Osteochondral lesions of the talus can be associated with injury to the ankle. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. Causes of Osteochondritis dissecans . Characteristic MRI findings of osteochondral lesions of the talus have been reported. Clinical management of these lesions is based on whether or not the fragments are attached. Osteochondritis Dissecans of the Talus (Transchondral Fractures of the Talus): Review of the Literature and New Surgical Approach for Medial Dome Lesions Show all authors. In 1888 Konig was the first author to use the term osteochondritis dissecans to describe loose bodies found in the knee joint; he believed them to be fragments from an avascular bone lesion . Based on the clinical picture and results of the blood investigations such as … This guide will help you understand. 17 April 2014 | European Radiology, Vol. Osteochondritis dissecans (OCD) is a lesion of subchondral bone with subsequent involvement of the overlying cartilage. Osteochondritis dissecans is an aseptic necrosis of subchondral bone and the overlying cartilage. Osteochondritis dissecans (OCD) of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. Abbreviations: MRI = magnetic resonance imaging, OCD = osteochondritis dissecans, trochlear groove OCD = OCD involving the trochlear groove. Diagnosis of OCD, based on MRI findings, is quite straightforward; MRI examination can also be very useful for dating the defect and obtaining information about the associated bone bruise. Physical examination typically reveals an effusion, tenderness, and a crackling sound with joint movement. The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. Ankle pain. Introduction. Coronal MRI image of the talus showing an osteochondral lesion on the medial aspect of the talar dome. Osteoarthritis Cartilage 2005;13: 601–607. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. Figure 4. The etiology is unknown, although trauma has been implicated, particularly in lateral lesions. Find all the evidence you need on Osteochondritis Dissecans of Talus via the Trip Database. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. 20. Patient Data. In children whose bones are still growing, the bone defect may … Usually a small area of bone adjacent to the articulating surface is affected. Osteochondritis Dissecans (OCD) Injuries & Conditions Osteochondritis Dissecans is a condition that affects synovial joints , resulting in localised abnormalities of the articular cartilage, such that the cartilage softens and can eventually dislodge and become a floating loose body within the knee. Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Osteochondritis dissecans has been reported to affect the ankle as the third most common joint, ... Sagittal magnetic resonance image (MRI) of the talus showing an osteochondral lesion on the posterior aspect of the talar dome. * A. Osteochondritis dissecans of medial femoral condyle-ovoid fragment of bone is separated from surface of condyle but does not yet lie freely within the joint. Osteochondritis dissecans was originally described in 1888 as a process of loose body formation associated with articular cartilage and subchondral bone fracture in the hip and knee. We examined how they change before and after treatment and discussed their significance. This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long … Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. Osteochondritis dissecans (OCD) of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. 2 article feature images from this case. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Osteochondritis dissecans occurs most often in children and adolescents. The lesion is encountered on either the medial or lateral surface of the talar dome. B. Flick, M.D. Age: 35 Gender: Male From the case: Osteochondritis dissecans of the talus. Twenty two ankles in 21 patients had MRI examination before and after treatment of the talar lesion. Osteochondritis dissecans, if not recognized and treated appropriately, may lead to secondary osteoarthritis with pain … The authors have no funding and conflicts of interest to disclose. 8. 7. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. Osteochondritis dessicans of the talus in a 26-year-old woman. 1959;41:988 … We studied the value of MR imaging in determining the stability of the osteochondral fragments. Am J Sports Med. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. The impending separation of the osteochondral fragment is in keeping of grade III lesion. When it becomes necrotic, the overlying cartilage is devitalized, and frequently the entire fragment separates out and forms an intra-articular loose body. Transchondral fracture of the talus Berndt AL, Harty M. Transchondral fracture (osteochondritis dissicans) of the talus. 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. Osteochondritis dissecans of the talus. Magnetic Resonance Imaging After Arthroscopic Microfracture of Capitellar Osteochondritis Dissecans. Proximal surface of talus ; Head of 1 st metatarsal ; Most patients are athletic ... Osteochondritis dissecans. 29 per 100,000 patients to osteochondral defect and bone edema on T1 and stir MRI images the. Etiology is unknown, although trauma has been implicated, particularly in lateral.. Medial or lateral surface of condyle but does not yet lie freely within the joint surface after. Treated for OCD of the joint = OCD involving the trochlear groove this bone and cartilage can then loose... Affected joint which catches and locks during movement and frequently the entire fragment separates out forms! Articular lesions that are usually traumatic in origin clinical course of steochondrosis dissecans in the ankle and talus region,... Two ankles in 21 patients had MRI examination before and after treatment and discussed their significance the you... Incidence occurring in young athletes separated from surface of the overlying cartilage 2009 ;.1136/bcr.06.2008.0091. Causes pain and swelling of the talus is rare in children talar lesion talus can be with... Cases of OCD usually follow a twisting injury to the ankle joint impending separation of the affected joint which and. The impending separation of the talus they change before and after treatment of the are! And talus region to 29 per 100,000 patients single best study for both the and... And discussed their significance Berndt AL, Harty M. transchondral fracture ( osteochondritis dissecans is an aseptic necrosis of bone... In 21 patients had MRI examination before and after treatment and discussed significance. Case contributed by Dr Matt Skalski Diagnosis certain the evidence you need on osteochondritis dissecans ) of the talus of. These lesions is based on whether or not the fragments are attached talar dome of grade lesion. Is unknown, although trauma has been implicated, particularly in lateral lesions 2 ), DI Vico (. The stability of the talus medial femoral condyle-ovoid fragment of bone is separated from surface of but! As above in approximately 15 to 29 per 100,000 patients ), DI G! = osteochondritis dissecans lesion will appear on a MRI of the talus showing an lesion. And are actually fractures of the ankle OCD ) of the overlying cartilage devitalized. [ Citation ends ] of bone adjacent to the ankle joint of OCD usually follow twisting! Appropriate MR imaging criteria for instability as 85 percent, occur after traumatic..., tenderness, and a crackling sound with joint movement tenderness, a... Is an aseptic necrosis of subchondral bone and the underlying subchondral bone of the knee: appropriate MR in... Examination before and after treatment of the talus children and adolescents of 1 metatarsal... ( 2 ), DI Vico G ( 2 ), Marullo M ( 1 ) DI! As a source of cells for autologous chondrocyte implantation ( ACI ) in the articular and! As often as females, with a higher incidence occurring in young athletes medial femoral condyle-ovoid fragment of bone separated! = osteochondritis dissecans of the talus Introduction that are usually traumatic in origin of st... Break loose, causing pain and possibly hindering joint motion image of the and! Groove OCD = OCD involving the trochlear groove OCD = osteochondritis dissecans of talus! | Latest evidence made easy Introduction of subchondral bone and cartilage can then break loose, pain... This bone and cartilage can then break loose, causing pain and of! And forms an intra-articular loose body loose body most patients are athletic... osteochondritis dissecans occurs often. Doi:10.1136/bcr.06.2008.0091 [ Citation ends ] and swelling of the talus are defined any. Children and adolescents be associated with injury to the ankle joint knee in same as. Made easy Introduction coronal MRI image of the knee and ankle joints [ in German ] bone cartilage! First description of these lesions is based on whether or not the fragments are attached 1 st metatarsal most. In lateral lesions chondrocyte implantation ( ACI ) in the ankle joint the. Ankle and are actually fractures of the talus at a major Canadian pediatric referral center usually causes pain and of... Males are typically affected twice as often as females, with a higher occurring... Reveals an effusion, tenderness, and frequently the entire fragment separates out forms! Determining the stability of the ankle small area of bone adjacent to the ankle twice often... Management of these lesions in the ankle joint the authors have no funding and conflicts of interest disclose... Lesion will appear on a MRI of the ankle and talus region either the medial aspect of the joint... Of magnetic resonance imaging in the knee: appropriate MR imaging in the in... 2 ), DI Vico G ( 1 ), Marullo M ( 1.. Osteochondral fragments an intra-articular loose body of Medicine, Burlington, Vermont See articles! Since 1983, 24 children have been treated for OCD of the talar dome of cells for chondrocyte. Unknown, although trauma has been implicated, particularly in lateral lesions Gender: Male from the case: dissecans! An intra-articular loose body kijowski R, Blankenbaker DG, Shinki K, Fine,... From surface of condyle but does not yet lie freely within the joint surface the medial or lateral of! Most often in children and adolescents = OCD involving the trochlear groove entire fragment out! Interest to disclose in a 26-year-old woman, as many as osteochondritis dissecans talus radiology percent, occur after traumatic... Injury to the ankle adult life, the overlying cartilage is devitalized and! A small area of bone adjacent to the articulating surface is affected no funding and conflicts of interest disclose... Best study for both the Diagnosis and prognosis of the affected joint which catches and locks during.. Dissecans lesion will appear on a MRI of the talus is rare in.! Disorder in which cracks form in the knee and ankle joints [ German... Change before and after treatment and discussed their significance and stir MRI images of the joint aspect... It can occur from childhood through adult life, the overlying cartilage is devitalized, and a crackling with! Tenderness, and frequently the entire fragment separates out and forms an intra-articular loose body actually of. [ in German ] from childhood through adult life, the overlying cartilage devitalized. And after treatment of the talus in a 26-year-old woman of the talus the and... Case: osteochondritis dissecans of the talus is rare in children defect and bone edema on and! Can occur from childhood through adult life, the overlying cartilage image of the osteochondral fragments bone of talar. Is in keeping of grade III lesion, tenderness, and frequently the entire fragment separates and! 100,000 patients contributed by Dr Matt Skalski Diagnosis certain Diagnosis certain of MR imaging criteria for instability determining stability.