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. Case contributed by Dr Vinay Shah. Diagnosis probable Diagnosis probable . Its therapy is determined by the stage of the lesion and MRI will become the method of choice for staging. On MRI, the cartilage can be visualized most clearly, including an assessment of the lateral cartilage margin of the capitellum, which is important in determining the course of treatment. Osteochondritis Dissecans (OCD) A contour change sharply demarcated that involves the chondro-osseous surface and appears to be chronic in nature may be characterized as an osteochondral defect; one subset of osteochondral defect that occurs in young patients is osteochondritis dissecans, which can be graded when there is history of trauma. Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society. Osteochondritis dissecans of the knee in children. Abstract. It often affects the femoral condyles (most common: posterolateral portion of medial condyle), talar dome, and humeral capitellum but can occur in all large joints. 94, No. The cause of this condition is unknown. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. 2018 Sep. 6 (9):2325967118794620. Although both radiography and magnetic resonance imaging (MRI) are routinely used to identify and evaluate osteochondritis dissecans lesions of the knee, MRI is often the imaging modality of choice and has been recommended as a technique to follow the healing response and degree of revascularization of the lesion 6,7. Knee Surg Sports Traumatol Arthrosc 2016; 24:1259–1264 [Google Scholar] Discrepancy between morphological findings in juvenile osteochondritis dissecans (OCD): a comparison of magnetic resonance imaging (MRI) and arthroscopy. 11 Imaging of Osteochondritis Dissecans This softening is caused by an interruption in the blood flow to that portion of the bone. Describing OCD together with osteochondral fractures and epiphyseal ossification disturbances and considering these three conditions as one entity has caused much confusion. Osteochondritis Dissecans Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. MRI is commonly used to assess the stability of OCD lesions of the knee . Background Several magnetic resonance imaging (MRI) classification systems have been developed to determine the degree of instability of juvenile osteochondritis dissecans (JOCD) lesions. Multiple systems for classifying osteochondritis dissecans (OCD) of the knee have been reported. 94, No. Osteochondritis dissecans is generally diagnosed by conventional radiology. MRI is most useful for classification and to determine the stability of the lesion. 2012 Sep 26. . Eur. Treatment can be conservative or surgical depending on how likely the OCD is to heal on its own. Osteochondritis dissecans (OCD) OCD represents a chronic “overload” injury of the epiphysis. Osteochondritis (osteochondrosis) dissecans (OCD) is a common condition in children, adolescents, and young adults. However, osteochondritis dissecans has been linked to: Repetitive trauma or stress on a joint, such as from playing sports; Genetic predisposition in some patients; Osteochondritis Dissecans Diagnosis and Treatment. Abstract. This is a well-known and validated classification system for OCD lesions. Osteochondritis dissecans (OCD) of the knee is an idiopathic, focal, subchondral-bone abnormality that can cause instability or detachment of a bone fragment and overlying articular cartilage, with subsequent progression to osteoarthritis. A comparison of MRI and arthroscopic finding. 8, 103±112 (1998) Ó Springer-Verlag 1998 European Musculoskeletal radiology Radiology Review article Osteochondritis (osteochondrosis) dissecans: A review and new MRI classification K. Bohndorf Department of Diagnostic Radiology and Neuroradiology, Central Clinics Augsburg, Stenglinstrasse 2, D-86 356 Augsburg, Germany Received 27 January 1997; Revision … ... MRI classification of OCD according Dipaola et al (Gr.I-IV) Treatment. Complaining of pain and clicking in right knee. In vivo visualization using MRI T2 mapping of induced osteochondrosis and osteochondritis dissecans lesions in goats undergoing controlled exercise; Novel Arthroscopic Classification of Osteochondritis Dissecans of the Knee – A Multicenter Reliability Study J Bone Joint Surg Am 2012; 94:1036. Osteochondritis dissecans. There is no verified classification of OCD of the elbow for CT images; therefore we used the classification of Clanton and DeLee 16 for osteochondritis dissecans of the knee. J Bone Joint Surg Br 2002;84:258-62. A Magnetic Resonance Imaging-Based Staging System for Osteochondritis Dissecans of the Elbow: A Validation Study Against the International Cartilage Repair Society Classification. The Clinical Utility and Diagnostic Performance of MRI for Identification and Classification of Knee Osteochondritis Dissecans The Journal of Bone and Joint Surgery-American Volume, Vol. 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. 5. The clinical utility and diagnostic performance of MRI for identification and classification of knee osteochondritis dissecans. J Bone Joint Surg Am 1996;78:439-56. MRI classification of juvenile osteochondritis dissecans lesions Hefti F, Beguiristain J, Krauspe R, et al. Osteochondritis dissecans (OCD) is an acquired defect in the articular cartilage and subchondral bone. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Roßbach BP, Paulus AC, Niethammer TR, et al. To diagnose osteochondritis dissecans, your orthopaedic specialist may request X-rays and an MRI of the joint. The following keywords were used: (“Osteochondritis Dissecans” OR “Osteochondrolysis” OR “Osteochondrosis Dissecans” OR “Osteochondral Defect”) AND ((Stability OR Instability) OR (Grade OR Grading OR Graded OR stage* OR Classification*)) AND (“MRI” OR “MRI” OR “MR”). Osteochondritis dissecans. Physical examination typically reveals an effusion, tenderness, and a crackling sound with joint movement. Osteochondritis dissecans (OCDs) are acquired disorders of bone in which there is fragmentation of the articular surface to varying degrees. Orthop J Sports Med . We define unstable OCD lesions as those with fragments that can be displaced by intraoperative probing. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. 1 The first description of these lesions in the ankle was provided in 1922. Magnetic Resonance Imaging After Arthroscopic Microfracture of Capitellar Osteochondritis Dissecans. Unstable OCDs require surgical intervention, whereas stable OCDs are generally treated conservatively. Schenck RC Jr, Goodnight JM. Osteochondritis dissecans: History, pathophysiology and current treatment concepts. 2008 Aug. 248(2):571-8 1. 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. OCD is a condition that affects the subchondral bone and potentially the overlying articular cartilage. The Clinical Utility and Diagnostic Performance of MRI for Identification and Classification of Knee Osteochondritis Dissecans The Journal of Bone and Joint Surgery-American Volume, Vol. Given the benefits of the use of MRI as a noninvasive tool to diagnose, predict lesion progression, and assess clinical outcomes of treatment, there is a pressing need for high-level, systematic, sound, and thorough studies related to the clinical utility of MRI for assessing osteochondritis dissecans of the knee. 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. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Am J Sports Med. [1] OCD usually causes pain and swelling of the affected joint which catches and locks during movement. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. CAFFEY J, MADELL SH, ROYER C, MORALES P. Ossification of the distal femoral epiphysis. Using radio waves and a strong magnetic field, an MRI can provide detailed images of both hard and soft tissues, including the bone and cartilage. These existing classification systems have some similar characteristics, such as stable lesion/intact articular cartilage and presence of a loose body. Clanton TO, DeLee JC. However, variations are found in the number of stages and specific lesion characteristics assessed. 11 MRI of Pediatric Patients: Part 2, Normal Variants and Abnormalities of the Knee It is classified into juvenile and adult forms, depending on growth plate status. 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