4(1):25-30. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Cartilage. Cystic lesion of the talar dome, cortical depression, or a loose bony fragment within the osteochondral defect may be demonstrated. 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. Lateral radiograph of the knee reveals a calcified loose body (arrowhead) posterior to the knee and lucency (arrow) in the articular surface of the patella. Athanasiou KA, Niederauer GG, Schenck RC Jr. Biomechanical topography of human ankle cartilage. 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. Tarsal navicular OCD does not demonstrate the classic radiographic appearance of Mueller-Weiss syndrome, which includes comma-shaped deformity of the navicular resulting from collapse of the lateral portion of the bone, bipartite navicular resulting from fracture, or protrusion of portions of the bone or the entire navicular bone, medially or dorsally. AJR Am J Roentgenol. 282 (3):798-806. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. AJR; 2012; 198: 1053-1068. 2012 Apr. Note the central location and absence of subchondral bone marrow edema. Orthop Traumatol Surg Res. Note the fluid in the subacromial/subdeltoid bursa and the supraspinatus tendon tear. [Medline]. (148):245-53. Berndt AL, Harty M. Transchondral fracture (osteochondritis dissecans) of the talus. Am J Sports Med. 41(A):988-1020. Unstable osteochondritis dissecans … 19 (5):307-9. Published by Elsevier Inc. NLM Treatment of unstable knee osteochondritis dissecans in the young adult: results and limitations of surgical strategies-The advantages of allografts to address an osteochondral challenge. Itsubo T, Murakami N, Uemura K, Nakamura K, Hayashi M, Uchiyama S, Kato H. Am J Sports Med. [32, 33, 34, 35, 36, 5, 10, 37, 13], T1-weighted sequences allow a detailed analysis of the bone signal. In some cases, you or your doctor will be able to feel a loose fragment inside your joint. Goldman AB, Hallel T, Salvati EM. HHS Int Orthop. [Medline]. [Medline]. Int Orthop. Filardo G, Andriolo L, Soler F, Berruto M, Ferrua P, Verdonk P, Rongieras F, Crawford DC. 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 … 2014 Aug;42(8):1972-7. doi: 10.1177/0363546514532604. Axial-gradient recall image reveals an osteochondral lesion in the anterior half of the glenoid. AJR Am J Roentgenol. [43] 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. Am J Sports Med. American Academy of Orthopaedic Surgeons clinical practice guideline on: the diagnosis and treatment of osteochondritis dissecans. February 1995. 2019 Aug;59(8):700-709. doi: 10.1007/s00117-019-0554-1. J Shoulder Elbow Surg. Journal Article, 2002 [Medline]. A report of two cases. [Medline]. [66] : Grade I - Intact, firm, shiny articular cartilage, Grade II - Intact but soft articular cartilage. Axial CT at the level of the ankle joint demonstrates lytic defect in the central and posterior portions of the tibial plafond. 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. Coronal CT of the ankle demonstrates a cortical depression in the tibial plafond. [38]  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. [Medline]. Pathology Location The condition occurs bilaterally in 25% of cases, … 1959. Sagittal T2-weighted image 1 year after injury reveals a subchondral cyst (arrow), an articular defect in the lateral tibial plateau, and a large knee effusion (arrowhead). A joint is where two bones come together. [13]. J Hand Surg [Am]. 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. 6th ed. 1993-4. Therefore, the … [Medline]. [Medline]. [11, 47] Disparity in frequency results from the biomechanical topography of the human ankle cartilage, since tibial cartilage is stiffer than talar cartilage. J Clin Ultrasound. Clin Sports Med. Clin Orthop. Axial CT of the ankle reveals osteochondritis dissecans in the posteromedial aspect of the talar dome. 2019 Jun;27(6):1726-1738. doi: 10.1007/s00167-018-5316-5. Debeer P, Brys P. Osteochondritis dissecans of the humeral head: clinical and radiological findings. [37], Kijowski et al retrospectively compared the sensitivity and specificity of previously described MRI criteria for the detection of instability in patients with juvenile or adult osteochondritis dissecans of the knee, with arthroscopic findings as the reference standard. Utilizing the ICRS classification system, for all three readers combined, the respective sensitivity, specificity, and accuracy of MR imaging to determine lesion stability were 70%, 81%, and 76%. Ferkel RD, Sgaglione NA. Am J Sports Med. 34 (5):266-71. [Medline]. 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). OCD of the tarsal navicular is limited to the proximal articular surface. OCD usually causes pain during and after sports. [71, 71], Satake et al found that MRI had a sensitivity of 84% for OCD, Arthroscopic treatment of osteochondral lesions of the talus: Long-term results. [Medline]. J Bone Joint Surg [Br]. Joint Bone Spine. Osteochondritis dissecans of the elbow. [Full Text]. MRI correlates best with surgical staging. J Pediatr Orthop. The OCD criteria of the ICRS were applied to arthroscopy and imaging interpretations. [Full Text]. [73] : 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. Epub 2014 May 9. Wood D, Carter KR. Posterior longitudinal sonogram reveals an unstable lesion with a slightly displaced fragment (asterisk) and a wide gap formation (arrows; courtesy of Dr Masatoshi Takahara). Osteochondrosis of the humeral capitellum. A comparison with conventional radiology and arthroscopy]. Clin Orthop. 2018 Feb. 104 (1S):S97-S105. MR imaging findings and MR criteria for instability in osteochondritis dissecans of the elbow in children. Crawford DC, Safran MR. Osteochondritis dissecans of the knee. J Bone Joint Surg Am. Rarely, OCD occurs in the medial tibial plateau (see the last 2 images below). 2019 Feb 1. The Anderson MRI classification of osteochondral lesions of the talus is as follows It is defined as a localized fragmentation of bone overlying the capitellum cartilage. [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. 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. However, inter-reader variability remained high, with Krippendorf's alpha ranging from 0.48 to 0.57. [10], In the ankle joint, helical CT has multiplanar capability. Curr Opin Pediatr. Conclusions: Three-Dimensional Quantitative Magnetic Resonance Imaging of Epiphyseal Cartilage Vascularity Using Vessel Image Features: New Insights into Juvenile Osteochondritis Dissecans. Crossref, Medline, Google Scholar; 7 DeSmet AA, Ilahi OA, Graf BK. Lindholm TS, Osterman K, Vankka E. Osteochondritis dissecans of elbow, ankle and hip: a comparison survey. 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. Nguyen JC, Degnan AJ, Barrera CA, Hee TP, Ganley TJ, Kijowski R. Osteochondritis Dissecans of the Elbow in Children: MRI Findings of Instability. [Medline]. 2019. 4(4):278-81. Paper presented at: Annual Meeting of the Academy of Orthopaedic Surgeons;. 2019 Apr. [Medline]. [Medline]. Radiology. [Guideline] Chambers HG, Shea KG, Anderson AF, et al. Anteroposterior radiograph of the leg reveals osteochondritis dissecans in the medial talar dome (arrowhead). 2018 Jun. [Medline]. Acta Radiol. [Full Text]. When it becomes necrotic, the … High-resolution MR imaging of talar osteochondral lesions with new classification. van Bergen CJ, van den Ende KI, Ten Brinke B, Eygendaal D. Osteochondritis dissecans of the capitellum in adolescents. [Medline]. Magnetic Resonance Imaging Staging to Evaluate the Stability of Capitellar Osteochondritis Dissecans Lesions. Because clinical findings are often subtle, diagnosis requires a high index of … J Pediatr Orthop. Kijowski R, De Smet AA. Early findings include subtle flattening or indistinct radiolucency about the cortical surface. [44] In a cadaveric study of the articular surfaces of the radiocapitellar joint, Schenck et al demonstrated significant topographic differences in the mechanical properties and thickness of cartilage in the capitellum and radial head. Joints. Gregersen HE, Rasmussen OS. Zanon G, DI Vico G, Marullo M. Osteochondritis dissecans of the knee. An osteochondral fragment may be present in situ, incompletely … 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. Often, the adjacent metaphysis reveals mild osteoporosis resulting from active hyperemia of the metaphysis. J Pediatr Orthop. 18(6):395-6. The MRI findings of unstable and stable osteochondritis dissecans of the capitellum are similar to the findings described for osteochondritis dissecans of the femoral condyles and talar dome. Sagittal T2-weighted image of the knee reveals subchondral bone marrow edema (white arrowhead) and an articular cartilage defect in the patella. Choi YS, Cohen NA, Potter HG, Mintz DN. If you log out, you will be required to enter your username and password the next time you visit. In the second stage, the epiphysis reveals an irregular contour and a thinning of the subcortical zone of rarefaction. Aghasi M, Rzetelni V, Axer A. Osteochondritis dissecans of the carpal scaphoid. Chambers HG, Shea KG, Carey JL. Mortise view of the ankle reveals lucency in the central portion of the tibial plafond (arrowhead). Douglas G, Rang M. The role of trauma in the pathogenesis of the osteochondroses. 1989 Sep-Oct. 30(5):552-4. Many patients with OCD of the femoral capital epiphysis have a prior history of Legg-Calve-Perthes Disease. 1995 Jul. [Medline]. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Anteroposterior radiograph of the knee reveals osteochondritis dissecans in the lateral aspect (arrowhead) of the medial femoral condyle. 12:91-2. Bachmann G, Jurgensen I, Siaplaouras J. Sagittal T2-weighted image of the knee demonstrates a calcified loose body (white arrowhead) in the infrapatellar fat pad. Mortise view of the ankle demonstrates a linear calcified loose body (arrowhead) in the talofibular joint and lucency in the lateral talar dome (arrow). If an o… 2016 Feb 18. [Medline]. 1980. Osteochondritis dissecans is suggested by a loss of the sharp cortical line of the articular surface (see the images below). Eur J Radiol. 1992. 2013 Apr. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. 2019 Dec 5;4(4):e0031.1-9. [Medline]. Bui-Mansfield LT, Kline M, Chew FS. [Medline]. [Medline]. It occurs when a small segment of bone begins to separate from its surrounding region … Perumal V, Wall E, Babekir N. Juvenile osteochondritis dissecans of the talus. 2006 Feb. 14(2):90-100. 2005 Dec. 185(6):1453-9. Oblique coronal T1-weighted image demonstrates a hypointense lesion in the inferior half of the glenoid. OCD is observed in approximately 3% of adults who had Legg-Calvé-Perthes disease as children. Ly JQ, Bui-Mansfield LT, Kline MJ, DeBerardino TM, Taylor DC. 81 (6):1306-10. 1995 Sep-Oct. 23(5):697-704. 34(7):1181-91. 33 (2):221-50. The lack of cartilage visualization can be overcome by using intra-articular contrast material. [Medline]. [67] : Grade A - Articular cartilage is smooth and intact but may be soft or ballottable, Grade B - Articular cartilage has a rough surface, Grade C - Articular cartilage has fibrillations or fissures, Grade D - Articular cartilage with a flap or exposed bone, Grade E - Loose, nondisplaced osteochondral fragment, Grade F - Displaced osteochondral fragment. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzkyMzk2LW92ZXJ2aWV3. 2017 Dec 20;39(6):768-773. doi: 10.3881/j.issn.1000-503X.2017.06.006. Singer KM, Roy SP. Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging. It may occur in either the distal or proximal pole and in either the distal or proximal articular surface of the scaphoid and may be bilateral. Anterior longitudinal sonogram demonstrates an unstable lesion with a capitellar defect (arrow; courtesy of Dr Masatoshi Takahara). Pappas AM. 1994. 94 (14):1322-4. Osteochondritis dissecans (OCD) is a localized process that affects the subchondral bone and can progress to the overlying articular cartilage. OCD of the glenoid is usually a much larger and eccentrically located lesion (see the last 4 images below). Kamhi E, MacEwen GD. Adv Orthop. 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 … Of horses are described, Nishiue S. osteochondritis dissecans of the glenoid: magnetic resonance imaging clinical! The right shoulder demonstrates a developmental defect of the ankle reveals a nondisplaced osteochondral fragment the evaluated joint in... Appearance with arthroscopic Staging in 56 % of the glenoid: magnetic resonance imaging and characteristics! 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Of variable severity Chair, Department of Radiology, Maimonides Medical CenterDisclosure: Nothing to disclose ] a short recovery... See the images below ) overcome by using intra-articular contrast material been described best in the posteromedial aspect the!: 10.1097/MOP.0000000000000308 5 are classified as unstable lesions of the articular surface ] Griffith JF, Lau,... Centerdisclosure: Nothing to disclose the infrapatellar fat pad results in compression and flattening of the humeral capitellum Among baseball... Planes at 1.5-mm-slice thickness with sagittal reformations V, Axer A. osteochondritis dissecans year injury... Distal tibia occur, suggesting trauma as a unique clinical and radiologic features of osteochondritis dissecans most! Is twice as sensitive as static scintigraphy in the talus of horses described.

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