Foot Ankle Int. 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). 17:1011. Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. 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. 2005 Aug. 71(4):484-8. Shoulder Elbow. The third stage is the period of repair in which granulation tissue gradually replaces the necrotic tissue. [Medline]. [Medline]. Correlation of magnetic resonance imaging to arthroscopic findings of stability in juvenile osteochondritis dissecans. Clin Orthop. doi: 10.2106/JBJS.OA.19.00031. [Full Text]. A report of four cases. Ly JQ, Bui-Mansfield LT, Kline MJ, DeBerardino TM, Taylor DC. Schenck RC Jr, Athanasiou KA, Constantinides G. A biomechanical analysis of articular cartilage of the human elbow and a potential relationship to osteochondritis dissecans. 2017 Dec 20;39(6):768-773. doi: 10.3881/j.issn.1000-503X.2017.06.006. Cartilage. 40 (2):363-86. [Medline]. [Medline]. Stoffelen D, Renson L, Fabry G. Osteochondritis dissecans of the acetabulum. J Comput Assist Tomogr. (148):245-53. [Medline]. 2007 Oct. 36(10):929-35. Anteroposterior radiograph of the knee is unremarkable. Arthroscopy. Introduction. Linden B, Nilsson BE. Satake H, Takahara M, Harada M, Maruyama M. Preoperative imaging criteria for unstable osteochondritis dissecans of the capitellum. 2002 [31], In the knee joint, the medial femoral condyle is the most commonly involved site. Locations of involvement were the anterosuperior, posterosuperior, posteromedial, superior, and medio-inferior aspects of the humeral head. 19 (5):307-9. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. Only 56% of the available MR reports assigned a label of stable or unstable to the lesion description. Crossref, Medline, Google Scholar; 7 DeSmet AA, Ilahi OA, Graf BK. In the second stage, the epiphysis reveals an irregular contour and a thinning of the subcortical zone of rarefaction. Clin Orthop. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. [75], Scintigraphic findings are nonspecific, demonstrating a mild-to-marked increase in focal uptake in the involved bone, depending on the age of the osteochondritis dissecans. Mortise view of the ankle demonstrates a linear calcified loose body (arrowhead) in the talofibular joint and lucency in the lateral talar dome (arrow). [Medline]. 2005 May. [Medline]. J Pediatr Orthop. Oblique, coronal T2-weighted image of the right shoulder demonstrates a developmental defect in the glenoid filled with fluid (arrowhead). MRI findings of osteochondritis dissecans of the capitellum with surgical correlation. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Clin Sports Med. 2018 Sep. 6 (9):2325967118794620. All types of OCD were also found to have a significantly greater average BMI when compared with patients without OCD. J Bone Joint Surg [Br]. [Medline]. 2016. Osteochondral fracture of the tarsal navicular is not as rare as previously reported in the radiologic literature. Conclusions: [Medline]. J Knee Surg. 2009 Mar. Radiology. [72] : Stage I - Bone marrow edema (subchondral trabecular compression; radiograph results are negative with positive bone-scan findings), Stage IIb - Incomplete separation of the osteochondral fragment, Stage III - Fluid around an undetached, undisplaced osteochondral fragment. Weiss JM, Shea KG, Jacobs JC Jr, Cannamela PC, Becker I, Portman M, et al. Int Orthop. Osteochondritis dissecans (OCD) is characterized by separation of an osteochondral fragment from the articular surface. 2018 Jun. 2019 Dec 5;4(4):e0031.1-9. Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD). Kamhi E, MacEwen GD. [Medline]. 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. Materials and methods: Athanasiou KA, Niederauer GG, Schenck RC Jr. Biomechanical topography of human ankle cartilage. Osteochondritis dissecans is suggested by a loss of the sharp cortical line of the articular surface (see the images below). 2018 Sep 23;2018:7912975. doi: 10.1155/2018/7912975. 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. Juvenile versus adult osteochondritis dissecans … Osteochondritis dissecans (OCD) is characterized by separation of an osteochondral fragment from the articular surface. 2018 May. In addition, tarsal OCD does not demonstrate either partial or complete sagittal fracture line on CT or MRI. Keywords: 2005 Dec. 185(6):1453-9. Griffith MRI classification of osteochondral lesions of the talus, showing the grade description of osteochondral lesions, is as follows Anderson IF, Crichton KJ, Grattan-Smith T. Osteochondral fractures of the dome of the talus. Differentials include Brodie abscess, chondroblastoma, enchondroma, and geode. Two arthroscopic classifications of osteochondral lesions of the talus are the Pritsch and Cheng surgical classifications, which are based on the appearance of the overlying articular cartilage as seen on arthroscopy. Clipboard, Search History, and several other advanced features are temporarily unavailable. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Pappas AM. 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 … A joint is where two bones come together. 2018 May/Jun. Anteroposterior radiograph of the knee reveals osteochondritis dissecans in the lateral aspect (arrowhead) of the medial femoral condyle. Filardo G, Andriolo L, Soler F, Berruto M, Ferrua P, Verdonk P, Rongieras F, Crawford DC. 6 De Smet A. Radiology of Osteochondritis Dissecans. 2008 Aug. 248(2):571-8. [Medline]. Although it can occur from childhood through adult life, the majority of patients are 10 to 20 years of … Bui-Mansfield LT, Kline M, Chew FS. Perhaps, the only potential differential diagnosis is a dorsal defect of the patella, which occur in the … In 1888, Konig coined the term when he sought to describe the pathologic process that led to atraumatic loose bodies … Background The name osteochondritis dissecans (OCD) is a misnomer. [Medline]. [13]. Paper presented at: Annual Meeting of the Academy of Orthopaedic Surgeons;. Anterior longitudinal sonogram reveals a stable lesion with localized subchondral bony flattening (arrows) and a normal outline of the articular cartilage (courtesy of Dr Masatoshi Takahara). AJR Am J Roentgenol. [4, 5, 6, 7, 8, 9]  Plain radiographs are limited in the ability to determine the stability of OCD lesions. Kijowski R, De Smet AA. The Ferkel and Sgaglione CT classification of osteochondral lesions of the talus is as follows [Medline]. [Medline]. 1994. … The intercondylar "notch" viewis very helpful. 282 (3):798-806. Please enable it to take advantage of the complete set of features! eCollection 2019 Oct-Dec. Radiologe. Radiographic findings correspond with arthroscopic staging in 56% of patients, because fibrosis may provide stability in osseous separation. Osteochondritis dissecans of the elbow. Liem T Bui-Mansfield, MD Adjunct Professor, Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Consulting Physician, Department of Radiology, Brooke Army Medical Center [Medline]. Rarely, OCD occurs in the medial tibial plateau (see the last 2 images below). OCD is limited to the articular epiphysis. [16, 39, 46, 69, 70, 17, 18, 15, 19, 20, 21], T1-weighted sequences allow a detailed analysis of the bone signal. Note the central location and absence of subchondral bone marrow edema. J Bone Joint Surg [Br]. [Medline]. [Full Text]. Osteochondritis dissecans is a condition that occurs in the joints (the place where the end of one bone meets the end of another bone) when a lack of blood to the joint causes the bone inside to soften. Bachmann G, Jurgensen I, Siaplaouras J. 89718-overview Kijowski R, De Smet AA. [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. Preoperative Evaluation of the Grade and Stability of Osteochondritis Dissecans of the Knee by Magnetic Resonance Imaging. [49], Sagittal T2-weighted image of the right shoulder reveals a central depression within the glenoid (arrowhead) without associated subchondral bone marrow edema. Routine MRI studies of 46 consecutive patients with arthroscopically proven OCD lesions (mean age: 23.7 years; 26 male, 16 female) were assessed by three radiologists who were blinded to arthroscopic results. 2017. Comparison of sonography and MRI in the evaluation of stability of capitellar osteochondritis dissecans. AJR Am J Roentgenol. Osteochondritis dissecans is the most common cause of a loose body in the joint space in adolescent patients. 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. [14] and Itsubo et al found 100% sensitivity and 80% specificity. [68] : Stage I - Normal radiograph (subchondral compression fracture of the talus with no ligamentous sprain), Stage II - Partially detached osteochondral fragment, Stage III - Complete, nondisplaced fracture remaining within the bony crater, Stage IV - Detached, loose osteochondral fragment, In the ankle joint, helical CT has multiplanar capability. [Medline]. Bare area of the glenoid: magnetic resonance appearance with arthroscopic correlation. Gregersen HE, Rasmussen OS. OCD of the tarsal navicular is limited to the proximal articular surface. 2006 Dec. 187 (6):1436-41. A comparison with conventional radiology and arthroscopy]. [Medline]. Jungesblut OD, Berger-Groch J, Meenen NM, Stuecker R, Rupprecht M. Validity of Ultrasound Compared with Magnetic Resonance Imaging in Evaluation of Osteochondritis Dissecans of the Distal Femur in Children. Drawing of osteochondritis dissecans of the capitellum with localized subchondral bony flattening and a normal articular surface. 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. 2018 Oct. 9 (4):346-362. Role of magnetic resonance imaging and clinical criteria in predicting successful nonoperative treatment of osteochondritis dissecans in children. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. This is a normal variant. Magnetic Resonance Imaging Staging to Evaluate the Stability of Capitellar Osteochondritis Dissecans Lesions. Wood D, Carter KR. 34 (5):266-71. Therefore, the … Lateral view of the ankle reveals loss of the sharp cortical line (arrowhead) in the posterior aspect of the tibial plafond. Diagnostic ultrasound in sports medicine: current concepts and advances. J Bone Joint Surg [Am]. The subchondral cyst and increased joint pressure may prevent healing. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzkyMzk2LW92ZXJ2aWV3. AJR Am J Roentgenol. Acta Orthop Scand. Sagittal T2-weighted image of the knee demonstrates a calcified loose body (white arrowhead) in the infrapatellar fat pad. 1987 Jan. 69(1):93-6. Radiographic findings can be subtle and, in some patients, may mimic Mueller-Weiss syndrome or stress fracture of the tarsal navicular. 18(6):395-6. Magnetic resonance imaging in the evaluation of osteochondritis dissecans of the patella. AJR; 2012; 198: 1053-1068. [Medline]. Int Orthop. Articular epiphyses fail as a result of compression. 1959.  |  Osteochondritis dissecans; grading scales; knee; magnetic resonance imaging. [Medline]. Magnetic Resonance Imaging Staging to Evaluate the Stability of Capitellar Osteochondritis Dissecans Lesions. Berndt AL, Harty M. Transchondral fracture (osteochondritis dissecans) of the talus. 1976 Dec. 47(6):668-71. It occurs when a small segment of bone begins to separate from its surrounding region … [Medline]. 2014 Jul-Sep. 2 (3):115-23. [Medline]. [Medline]. In patients with capitellar OCD, MRI is particularly helpful for identifying cartilaginous foreign bodies that are usually missed by plain radiographs. [1, 2, 3]  Osteochondritis dissecans occurs in approximately 15 to 29 per 100,000 patients. Guelpa G, Chamay A, Lagier R. Bilateral osteochondritis dissecans of the carpal scaphoid. 2004 Mar-Apr. Am J Sports Med. Arthroscopic treatment of osteochondritis dissecans of the scaphoid. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. [4, 48, 49, 50, 51, 52, 53, 54], Occasionally, OCD of the tarsal navicular (see the images below) is seen on ankle radiographs. Satake et al found that MRI had a sensitivity of 84% for OCD, 34(5):266-71. Jacobson JA. Hamada S, Hamada M, Nishiue S. Osteochondritis dissecans of the humeral head. 2 (1):29-36. Epub 2014 May 9. Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. [The staging of osteochondritis dissecans in the knee and ankle joints with MR tomography. [Medline]. Am J Sports Med. Osteochondritis dissecans occurs in approximately 15 to 29 per 100,000 patients. To our surprise, the analysis of the existing radiology reports that addressed stability revealed an overall accuracy in defining OCD lesion stability of about 53%. Skeletal Radiol. The Pritsch arthroscopic staging of osteochondral lesions of the talus is as follows Reassessment of the MR criteria for stability of osteochondritis dissecans … Coronal CT of the ankle demonstrates a cortical depression in the tibial plafond. Lateral radiograph of the ankle reveals a cortical depression and loss of the sharp cortical line in the proximal articular surface of the tarsal navicular (arrowhead). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. 1992. [15, 16, 17, 18, 19, 20, 21], Ultrasonography has been used to evaluate osteochondritis dissecans of the knee and humeral capitellum. Joints. Ishibe M, Ogino T, Sato Y. Osteochondritis dissecans of the distal radioulnar joint. Wood JB, Klassen RA, Peterson HA. MRI correlates best with surgical staging. Leon Lenchik, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Radiological Society of North AmericaDisclosure: Nothing to disclose. [Medline]. To diagnose osteochondritis dissecans, your orthopaedic specialist may request X-rays and an MRI … Novel radiographic feature classification of knee osteochondritis dissecans: a multicenter reliability study. Developmental defect of the glenoid is a small focal defect within the center of the glenoid and without associated subchondral bone marrow edema. [Full Text]. Three-Dimensional Quantitative Magnetic Resonance Imaging of Epiphyseal Cartilage Vascularity Using Vessel Image Features: New Insights into Juvenile Osteochondritis Dissecans. Canosa J. Usually a small area of bone adjacent to the articulating surface is affected. Linden B. Knee Osteochondritis Dissecans. 41(4):387-99. Axial-gradient recall image reveals an osteochondral lesion in the anterior half of the glenoid. Pill SG, Ganley TJ, Milam RA, Lou JE, Meyer JS, Flynn JM. 4(4):278-81. AJR Am J Roentgenol.  |  Mirror image osteochondral defects of the talus and distal tibia. This retrospective study on OCD reporting and classification highlights the inadequacy of existing classification schemes, and emphasizes the critical need for improved diagnostic MRI protocols in musculoskeletal radiology in order to propel it toward evidence-based medicine. Leon Lenchik, MD Program Director and Associate Professor of Radiologic Sciences-Radiology, Wake Forest University Baptist Medical Center 2018 Feb. 104 (1S):S97-S105. 2019. Diseases & Conditions, 2002 2012 Apr. AJR Am J Roentgenol. Arthroscopic- operative treatment. Singer KM, Roy SP. Douglas G, Rang M. The role of trauma in the pathogenesis of the osteochondroses. Epub 2015 Jul 26. 2012 Jun. [Medline]. [Medline]. 392396-overview Posterior longitudinal sonogram demonstrates a stable lesion with a nondisplaced bone fragment (asterisk), intact articular surface (arrowheads), and a narrow gap formation (arrow; courtesy of Dr Masatoshi Takahara). 12:91-2. [Medline]. [Medline]. [74, 22, 20, 23, 24, 25, 26], Kida et al reported 100% positive predictive value for ultrasound screening for OCD and suggested that a distinctive loss of the smooth articular surface on ultrasound was a good indicator of an osteochondral lesion. The Cheng arthroscopic staging of osteochondral lesions of the talus is as follows Javier Beltran, MD Chair, Department of Radiology, Maimonides Medical CenterDisclosure: Nothing to disclose. [Medline]. Churchill RW, Munoz J, Ahmad CS. Arthroscopic images were evaluated by two orthopedic surgeons in consensus. 2019 Nov. 213 (5):1145-1151. Nguyen JC, Degnan AJ, Barrera CA, Hee TP, Ganley TJ, Kijowski R. Osteochondritis Dissecans of the Elbow in Children: MRI Findings of Instability. 6(4):351-2. Because clinical findings are often subtle, diagnosis requires a high index of … AJR Am J Roentgenol. [22, 20, 23, 24, 25, 26], Scintigraphic findings are nonspecific, demonstrating a mild-to-marked increase in focal uptake in the involved bone, depending on the age of the osteochondritis dissecans. 1989 Sep. 14(5):818-21. Osteochondritis dissecans of the femoral sulcus has been recognized as a unique clinical and radiographic entity, warranting early diagnosis and appropriate treatment. Insights into the Epiphyseal Cartilage Origin and Subsequent Osseous Manifestation of Juvenile Osteochondritis Dissecans with a Modified Clinical MR Imaging Protocol: A Pilot Study. [11, 47] Disparity in frequency results from the biomechanical topography of the human ankle cartilage, since tibial cartilage is stiffer than talar cartilage. Am J Sports Med. 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. The clinical and radiologic features of osteochondritis dissecans in the knee and hock joint of horses are described. [50] : Stage I - Cystic lesion of the talar dome with an intact roof, Stage IIa - Cystic lesion with communication to the talar dome surface, Stage IIb - Open articular surface lesion with an overlying, nondisplaced fragment, Stage III - Nondisplaced lesion with lucency, Stage IV - Displaced osteochondral fragment, MRI detects radiographically occult lesions that may not be detected on CT. MRI is the preferred imaging method to characterize OCD lesions and ascertain their stability. The patella is a less common site for osteochondritis dissecans (OCD) of the knee. Osteochondritis dissecans of the tarsal navicular bone: imaging findings in four patients. [59, 22, 60, 61]. Oblique coronal T2-weighted fat-suppression image demonstrates a hyperintense osteochondral lesion in the inferior half of the glenoid. Debeer P, Brys P. Osteochondritis dissecans of the humeral head: clinical and radiological findings. CT scans can be used to assess the osseous integration after refixation of OCD loose fragments. A 20-year follow-up study. 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. Orthop J Sports Med. Osteochondritis dissecans … 1989 Sep-Oct. 30(5):552-4. A report of two cases. [Medline]. 2007 Oct-Nov. 27(7):821-5. Arthroscopic classifications of osteochondral lesions are the criterion standard. [15]. [10], In the ankle joint, helical CT has multiplanar capability. CONCLUSION. JB JS Open Access. High-resolution MR imaging of talar osteochondral lesions with new classification. Clin Orthop Relat Res. 1993-4. 2005 May. Ellermann J, Johnson CP, Wang L, Macalena JA, Nelson BJ, LaPrade RF. Joint Bone Spine. [Medline]. 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