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