[Medline]. doi: 10.2106/JBJS.OA.19.00031. 1981 Jul-Aug. (158):28-32. [Full Text]. Berndt AL, Harty M. Transchondral fracture (osteochondritis dissecans) of the talus. This article is a review of the current understanding of the etiology, pathogenesis, and how to diagnose and treat knee osteochondritis dissecans (OCD) followed by an analysis of and outcomes of the … [Medline]. The usual sites of OCD of the talar dome are the posteromedial aspect (56%) and the anterolateral aspect (44%) of the talus. Drawing of osteochondritis dissecans of the capitellum with a slightly displaced fragment. 2018 May. [4, 5, 6, 8, 10, 9]. Sagittal T2-weighted image of the knee reveals subchondral bone marrow edema (white arrowhead) and an articular cartilage defect in the patella. 1980. Articular epiphyses fail as a result of compression. 2019 Aug;59(8):700-709. doi: 10.1007/s00117-019-0554-1. Linden B. Journal Article, 2002 2019 Apr. Joint Bone Spine. Adv Orthop. Coronal CT of the ankle demonstrates a cortical depression in the tibial plafond. Ultrasound in sports medicine. Orthop J Sports Med. [Medline]. 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. Radiology; 1998;5: Reprint. 68(6):862-5. 1989 Sep. 71(8):1143-52. J Bone Joint Surg Am. OCD is suggested by a loss of the sharp cortical line of the articular surface. [Full Text]. 2 (1):29-36. [Medline]. The lack of cartilage visualization can be overcome by using intra-articular contrast material. Oblique sagittal T2-weighted fat-suppression image reveals a large lesion in the anterior and inferior aspects of glenoid. [Medline]. Liem T Bui-Mansfield, MD is a member of the following medical societies: American Roentgen Ray Society, International Skeletal Society, Radiological Society of North America, Society of Skeletal RadiologyDisclosure: Nothing to disclose. Viegas SF. Goldman AB, Hallel T, Salvati EM. Am J Sports Med. [Medline]. HHS In patients with capitellar OCD, MRI is particularly helpful for identifying cartilaginous foreign bodies that are usually missed by plain radiographs. [Medline]. 21(2):106-15. The Ferkel and Sgaglione CT classification of osteochondral lesions of the talus is as follows Kijowski R, De Smet AA. In 1888, Konig coined the term when he sought to describe the pathologic process that led to atraumatic loose bodies … Satake et al found that MRI had a sensitivity of 84% for OCD, Because clinical findings are often subtle, diagnosis requires a high index of … Cystic lesion of the talar dome, cortical depression, or a loose bony fragment within the osteochondral defect may be demonstrated. 94 (14):1322-4. The OCD criteria of the ICRS were applied to arthroscopy and imaging interpretations. 1981 Jul-Aug. (158):59-69. 1988. [67] : Grade A - Articular cartilage is smooth and intact but may be soft or ballottable, Grade B - Articular cartilage has a rough surface, Grade C - Articular cartilage has fibrillations or fissures, Grade D - Articular cartilage with a flap or exposed bone, Grade E - Loose, nondisplaced osteochondral fragment, Grade F - Displaced osteochondral fragment. Osteochondritis dissecans (OCD) is characterized by separation of an osteochondral fragment from the articular surface. Accadbled F, Vial J, Sales de Gauzy J. Osteochondritis dissecans of the knee. Of these, 58% of the lesions were deemed unstable and 42% were stable. Only 56% of the available MR reports assigned a label of stable or unstable to the lesion description. It is felt that the osteochondritis dissecans can be explained on the basis of the history of trauma, which was slight but repeated in character. 282 (3):798-806. Strontium-85 uptake in knee joints with osteochondritis dissecans. The shortcomings of CT are applied radiation, especially in pediatric patients, and lack of cartilage visualization. All types of OCD were also found to have a significantly greater average BMI when compared with patients without OCD. Detterline AJ, Goldstein JL, Rue JP, Bach BR Jr. [Medline]. 1995 May-Jun. Clin Orthop. 41(A):988-1020. 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. In 7 patients with OCD of the humeral head (all males ranging in age from 12 to 44 year), 5 of the patients (71%) demonstrated lesions in the right shoulder, suggesting an association with right-handedness. Bachmann G, Jurgensen I, Siaplaouras J. [Medline]. [Full Text]. Published by Elsevier Inc. NLM If you log out, you will be required to enter your username and password the next time you visit. 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. A preliminary report. Osteochondral fracture of the tarsal navicular is not as rare as previously reported in the radiologic literature. Takahara M, Ogino T, Tsuchida H. Sonographic assessment of osteochondritis dissecans of the humeral capitellum. This is a normal variant. [50, 55, 56, 57, 58], OCD rarely occurs in the shoulder joint, where it involves either the humeral head or the glenoid. [15]. Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Management of osteochondritis dissecans of the knee: current concepts review. 23 (2):213-219. J Pediatr Orthop. [Medline]. 2018 May/Jun. 2015 Jan;46(1):133-9. doi: 10.1016/j.ocl.2014.09.009. Osteochondrosis 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). Your doctor will also check other structures around the joint, such as the ligaments.Your doctor will also ask you to move your joint in different directions to see whether the joint can move smoothly through its normal range of motion. 1992. New Orleans, LA. In the second stage, the epiphysis reveals an irregular contour and a thinning of the subcortical zone of rarefaction. 41(4):387-99. Incidence of Osteochondritis Dissecans in Adults. 2018 Feb. 104 (1S):S97-S105. Osteochondritis dissecans is suggested by a loss of the sharp cortical line of the articular surface (see the images below). A clinical survey. Radiol Clin North Am. Sports Med Arthrosc Rev. J Pediatr Orthop. When detectable, osteochondral lesions appear as lucencies in the articular epiphysis. Shoulder Elbow. [Medline]. Introduction. Orthop Trans. Bernard D Coombs, MB, ChB, PhD Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New ZealandDisclosure: Nothing to disclose. 2016 Jun. For a general discussion of osteochondritis dissecans … 2006 Dec. 187 (6):1436-41. A radiological and anatomical study of one case. AJR Am J Roentgenol. AJR Am J Roentgenol. Paper presented at: Annual Meeting of the Academy of Orthopaedic Surgeons;. Joints. [10], In the ankle joint, helical CT has multiplanar capability. [Medline]. OCD of the elbow is a subchondral bone lesion without evidence of acute trauma and is characterized by various degrees of osseous collapse, resorption, and sequestrum formation, which often involves articular cartilage delamination. Oblique coronal T2-weighted fat-suppression image demonstrates a hyperintense osteochondral lesion in the inferior half of the glenoid. Kijowski R, Blankenbaker DG, Shinki K, et al. 1959. Kohyama S, Ogawa T, Mamizuka N, Hara Y, Yamazaki M. A Magnetic Resonance Imaging-Based Staging System for Osteochondritis Dissecans of the Elbow: A Validation Study Against the International Cartilage Repair Society Classification. Am J Sports Med. eCollection 2019 Oct-Dec. Radiologe. [Medline]. [38]  It is typically found in young athletes involved in overhead-throwing sports, such as baseball, at a time when the epiphyseal growth plate is open. J Comput Assist Tomogr. The advantage of ultrasound is dynamic scanning with motion of the evaluated joint. Knee Surg Sports Traumatol Arthrosc. … The knee, particularly the lateral aspect of the medial femoral condyle, is the most affected joint, and the elbow (capitellum) and ankle (talus) are affected to a lesser degree. [The staging of osteochondritis dissecans in the knee and ankle joints with MR tomography. 1981 Jul. Bauer M, Jonsson K, Linden B. Osteochondritis dissecans of the ankle. 2005 Aug. 71(4):484-8. Clin Orthop. Jacobs JC Jr, Archibald-Seiffer N, Grimm NL, Carey JL, Shea KG. Kida Y, Morihara T, Kotoura Y, Hojo T, Tachiiri H, Sukenari T, et al. Kessler JI, Jacobs JC Jr, Cannamela PC, Shea KG, Weiss JM. 2015 Feb. 43 (2):303-9. Yoshizuka M, Sunagawa T, Nakashima Y, Shinomiya R, Masuda T, Makitsubo M, et al. J Am Acad Orthop Surg. [Medline]. Comparison of sonography and MRI in the evaluation of stability of capitellar osteochondritis dissecans. 2000 Feb. 174(2):411-5. OCD of the tarsal navicular is limited to the proximal articular surface. The scintigraphic appearance is probably a result of the slow repair process around an OCD, involving only the bone tissue surrounding the lesion, and is not a result of the OCD itself. 1994. 163(1):38-44. Hamada S, Hamada M, Nishiue S. Osteochondritis dissecans of the humeral head. 2019 Nov. 213 (5):1145-1151. [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. 6th ed. Three-Dimensional Quantitative Magnetic Resonance Imaging of Epiphyseal Cartilage Vascularity Using Vessel Image Features: New Insights into Juvenile Osteochondritis Dissecans. Three-dimensional gradient echo sequences with various fat suppression techniques provide a detailed assessment of the cartilage and differentiate the epiphyseal cartilage from the surface cartilage by showing a thin low-signal line between the layers. [4, 48, 49, 50, 51, 52, 53, 54], Occasionally, OCD of the tarsal navicular (see the images below) is seen on ankle radiographs. [Medline]. McCullough RW, Gandsman EJ, Litchman HE. Magnetic Resonance Imaging Staging to Evaluate the Stability of Capitellar Osteochondritis Dissecans Lesions. 2016. 2008 Apr. In some cases, you or your doctor will be able to feel a loose fragment inside your joint. OCD usually causes pain during and after sports. [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. Although it can occur from childhood through adult life, the majority of patients are 10 to 20 years of … Osteochondritis dissecans is a joint condition that occurs when a piece of cartilage and the thin layer of bone beneath it, separates from the end of the bone.If the piece of cartilage and bone … AJR Am J Roentgenol. The intercondylar "notch" viewis very helpful. 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. Physical examination in the early stages does only show pain as symptom, in later stages there could be an effusion, tenderness, and a crackling sound with joint movement. 2020 Aug;12(4):284-293. doi: 10.1177/1758573218821151. J Bone Joint Surg [Am]. Churchill RW, Munoz J, Ahmad CS. [Medline]. 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 … … Mortise view of the ankle reveals lucency in the central portion of the tibial plafond (arrowhead). Cartilage. Knee Osteochondritis Dissecans. The classification system of the ICRS, created by an international multidisciplinary, multi-expert consortium, did markedly improve the accuracy, but consistency among different readers was lacking. [43] Singer and Roy proposed that repeated valgus stress and a tenuous blood supply within the capitellum explain the frequent occurrence of OCD in this location. High-resolution MR imaging of talar osteochondral lesions with new classification. Discrepancy between morphological findings in juvenile osteochondritis dissecans (OCD): a comparison of magnetic resonance imaging (MRI) and arthroscopy. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Aichroth P. Osteochondritis dissecans of the knee. 34(7):1181-91. This trauma was produced by the action of the head of the … An osteochondral fragment may be present in situ, incompletely detached, or completely detached. [Medline]. J Shoulder Elbow Surg. [Medline]. In addition, moderate obesity is associated with an increased risk of knee OCD. Preoperative Evaluation of the Grade and Stability of Osteochondritis Dissecans of the Knee by Magnetic Resonance Imaging. Grades 2b, 4b, and 5 are classified as unstable lesions of variable severity. [Full Text]. Osteochondritis dissecans of the tibial plafond: imaging characteristics and a review of the literature. 1993-4. A comparison with conventional radiology and arthroscopy]. 1984 Sep-Oct. 12(5):351-60. Satake H, Takahara M, Harada M, Maruyama M. Preoperative imaging criteria for unstable osteochondritis dissecans of the capitellum. A review of arthroscopic classification systems for osteochondritis dissecans of the knee. Axial CT of the knee demonstrates a completely detached osteochondral fracture (arrowhead) in the lateral aspect of the medial femoral condyle. Clin Orthop. [Medline]. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Zanon G, DI Vico G, Marullo M. Osteochondritis dissecans of the knee. 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