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