With radionuclide scanning, findings between stable and unstable fragments overlap. The cause of this lesion remains elusive. Osteochondritis dissecans can be classified at surgery into 4 stages: Classification according to International Cartilage Repair Society. With the vague clinical symptoms and signs of OCD, imaging plays a vital role in making the diagnosis and helping with the prognosis of OCD lesions. OCD lesions occur when an area of discrete articular surface begins to separate from the damaged underlying subchondral bone. It should also provide valuable information about articular cartilage repair tissue after surgery. Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint Cartilage . The itis suffix of osteochondritis denotes the previously understood cause of inflammation of the osteochondral joint surface. Request PDF | Osteochondritis Dissecans of the Elbow | Osteochondritis dissecans (OCD) is a disorder of articular cartilage and subchondral bone. 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. Franz Konig introduced the term osteochondritis dissecans in 1888, although it was originally described by Paget some years earlier. 1. repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity 1.1. valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the etiology for OCD of the capitellum 8 2. ankle sprain/instability 2.1. Potential limitations of such sequences include their long acquisition times as well as their susceptibility to metal artifacts, which may be an important consideration after surgery. Onset is between childhood and middle age, with the majority of patients being between 10 and 40 years of age, with approximately a 2:1 male to female ratio 3. Osteochondritis dissecans typically affects the lateral surface of the medial femoral condyle in adolescent males. 2 ). Rationale and objectives: In this retrospective case series, we utilize arthroscopy as the gold standard to determine if magnetic resonance imaging (MRI) of the knee can predict osteochondritis dissecans (OCD) lesion stability, the most important information to guide patient treatment decisions. MR imaging can detect the presence of OCD in the early stages when radiographs are normal or show only subtle changes. Osteochondritis dissecans (OCD) most commonly affects the knee. Cysts surrounding a juvenile OCD lesion indicated instability only if they were multiple or large (>5 mm) in size. Dissecans is derived from Latin and means to separate. (, A 15-year-old boy with an unstable juvenile OCD lesion of medial femoral condyle. Bone scintigraphy has not been shown to provide reliable information about an OCD lesion’s stability; as such, it has limited usefulness in differentiating surgical versus nonsurgical lesions. 1 ). With the vague clinical symptoms and signs of OCD, imaging plays a vital role in making the diagnosis and helping with the prognosis of OCD lesions. Prevalence of this condition ranges between 15 and 29 per 100,000, with an increased male predominance of 2:1. Physical examination typically reveals an effusion, tenderness, and a crackling sound with joint movement. Bone scintigraphy also provides no anatomic information on articular surface deformity. Characteristic radiographic findings include a well-circumscribed area of subchondral bone separated by a crescent-shaped radiolucent outline of the fragment. (, A 21-year-old man with an unstable adult OCD lesion of the lateral femoral condyle. It is hypothesized that the classification system of the International Cartilage Repair Society (ICRS) will allow for improved assessment of lesion grade and stability in OCD. The ultimate cause of OCD lesions is unknown at this time, but is likely multifactorial, with mechanical causal factors being most important. Features are consistent with osteochondritis dissecans of the ankle joint. A 14-year-old male patient with an OCD lesion on the lateral femoral condyle. 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. MRI at 3.0 T has the potential advantage of imaging with higher spatial resolution at similar imaging acquisition times, compared with 1.5-T imaging. A Magnetic Resonance Imaging-Based Staging System for Osteochondritis Dissecans of the Elbow: A Validation Study Against the International Cartilage Repair Society Classification These MRI criteria include (1) a rim of high signal intensity surrounding an OCD lesion on T2-weighted images (hereafter referred to as high T2 signal intensity), (2) cysts surrounding an OCD lesion, (3) a fracture line of high T2 signal intensity extending through the articular cartilage overlying an OCD lesion, and (4) a fluid-filled osteochondral defect. In general, conventional radiographs are poor at establishing the stability and size of the lesion and are unable to assess the status of the overlying cartilage. These techniques have been investigated as potential tools to characterize the histologic and biochemical composition and temporal maturation of repair tissue following osteochondral repair procedures. This technique was initially thought useful in determining the need for operative intervention for lesions that show increased activity on bone scan despite conservative treatment. However, these advantages come at the cost of converting a noninvasive examination (conventional MRI) to an invasive procedure, and there are the potential complications inherent to intra-articular injection of contrast material. This article reviews current imaging modalities for the assessment of OCD including conventional radiography, nuclear medicine, computed tomography (CT), CT arthrography, magnetic resonance (MR) and MR arthrography. See osteochondritis dissecans article for a general discussion. Materials and methods: This prospective study was approved by our institutional review board and all patients gave informed consent. “MR Imaging Features of Osteochondritis Dissecans of the Femoral Sulcus.” Am. The dGEMRIC imaging technique, which displays the distribution of negatively charged gadolinium-based MRI contrast material (gadopentetate dimeglumine) within cartilage, has been validated as an accurate marker of cartilage tissue glycosaminoglycan (GAG) concentration. Osteochondritis dissecans (OCD) is a localized process that affects the subchondral bone and can progress to the overlying articular cartilage. The skyline view allows for visualization of the femoral trochlea, an uncommon but problematic location for OCD lesions. However, subsequent studies using the revised criteria of Kijowski and colleagues showed sensitivities and specificities approaching 100%. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. 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