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