The Clinical Utility and Diagnostic Performance of MRI for Identification and Classification of Knee Osteochondritis Dissecans The Journal of Bone and Joint Surgery-American Volume, Vol. Physical examination typically reveals an effusion, tenderness, and a crackling sound with joint movement. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. Treatment can be conservative or surgical depending on how likely the OCD is to heal on its own. It often affects the femoral condyles (most common: posterolateral portion of medial condyle), talar dome, and humeral capitellum but can occur in all large joints. Diagnosis probable Diagnosis probable . Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Osteochondritis (osteochondrosis) dissecans (OCD) is a common condition in children, adolescents, and young adults. 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. Given the benefits of the use of MRI as a noninvasive tool to diagnose, predict lesion progression, and assess clinical outcomes of treatment, there is a pressing need for high-level, systematic, sound, and thorough studies related to the clinical utility of MRI for assessing osteochondritis dissecans of the knee. Roßbach BP, Paulus AC, Niethammer TR, et al. This softening is caused by an interruption in the blood flow to that portion of the bone. A comparison of MRI and arthroscopic finding. 2008 Aug. 248(2):571-8 J Bone Joint Surg Br 2002;84:258-62. Rationale and Objectives: In this retrospective case series, we utilize arthroscopy as the gold standard to determine if magnetic resonance imaging (MRI) of the knee can predict osteochondritis dissecans (OCD) lesion stability, the most important information to guide patient treatment decisions. Introduction. 1 The first description of these lesions in the ankle was provided in 1922. CAFFEY J, MADELL SH, ROYER C, MORALES P. Ossification of the distal femoral epiphysis. Abstract. 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. Osteochondritis dissecans of the knee in children. The Clinical Utility and Diagnostic Performance of MRI for Identification and Classification of Knee Osteochondritis Dissecans The Journal of Bone and Joint Surgery-American Volume, Vol. Osteochondritis dissecans (OCD) of the knee is an idiopathic, focal, subchondral-bone abnormality that can cause instability or detachment of a bone fragment and overlying articular cartilage, with subsequent progression to osteoarthritis. Background Several magnetic resonance imaging (MRI) classification systems have been developed to determine the degree of instability of juvenile osteochondritis dissecans (JOCD) lesions. Eur. [1] OCD usually causes pain and swelling of the affected joint which catches and locks during movement. 8, 103±112 (1998) Ó Springer-Verlag 1998 European Musculoskeletal radiology Radiology Review article Osteochondritis (osteochondrosis) dissecans: A review and new MRI classification K. Bohndorf Department of Diagnostic Radiology and Neuroradiology, Central Clinics Augsburg, Stenglinstrasse 2, D-86 356 Augsburg, Germany Received 27 January 1997; Revision … Osteochondritis dissecans (OCDs) are acquired disorders of bone in which there is fragmentation of the articular surface to varying degrees. To diagnose osteochondritis dissecans, your orthopaedic specialist may request X-rays and an MRI of the joint. A Magnetic Resonance Imaging-Based Staging System for Osteochondritis Dissecans of the Elbow: A Validation Study Against the International Cartilage Repair Society Classification. Osteochondritis dissecans was originally described in 1888 as a process of loose body formation associated with articular cartilage and subchondral bone fracture in the hip and knee. Radiology. Unstable OCDs require surgical intervention, whereas stable OCDs are generally treated conservatively. Clanton TO, DeLee JC. The following keywords were used: (“Osteochondritis Dissecans” OR “Osteochondrolysis” OR “Osteochondrosis Dissecans” OR “Osteochondral Defect”) AND ((Stability OR Instability) OR (Grade OR Grading OR Graded OR stage* OR Classification*)) AND (“MRI” OR “MRI” OR “MR”). Schenck RC Jr, Goodnight JM. The clinical utility and diagnostic performance of MRI for identification and classification of knee osteochondritis dissecans. Presentation. It is classified into juvenile and adult forms, depending on growth plate status. Multiple systems for classifying osteochondritis dissecans (OCD) of the knee have been reported. Osteochondritis dissecans (OCD) OCD represents a chronic “overload” injury of the epiphysis. Osteochondritis Dissecans Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. 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. Osteochondritis dissecans: History, pathophysiology and current treatment concepts. J Bone Joint Surg Am 2012; 94:1036. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. Discrepancy between morphological findings in juvenile osteochondritis dissecans (OCD): a comparison of magnetic resonance imaging (MRI) and arthroscopy. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. ... MRI classification of OCD according Dipaola et al (Gr.I-IV) Treatment. To determine whether pains are osteochondritis dissecans, an MRI, CT scan or X-ray can be performed to show necrosis of subchondral bone and/or formation of loose fragments.In specific cases, if caught early enough, a harmless dye will be injected into the blood stream to show where calcium will accumulate. Describing OCD together with osteochondral fractures and epiphyseal ossification disturbances and considering these three conditions as one entity has caused much confusion. Osteochondritis Dissecans (OCD) A contour change sharply demarcated that involves the chondro-osseous surface and appears to be chronic in nature may be characterized as an osteochondral defect; one subset of osteochondral defect that occurs in young patients is osteochondritis dissecans, which can be graded when there is history of trauma. OCD is a condition that affects the subchondral bone and potentially the overlying articular cartilage. This is a well-known and validated classification system for OCD lesions. MRI is commonly used to assess the stability of OCD lesions of the knee . MRI is most useful for classification and to determine the stability of the lesion. Magnetic resonance imaging (MRI). Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Knee Surg Sports Traumatol Arthrosc 2016; 24:1259–1264 [Google Scholar] The cause of this condition is unknown. Although both radiography and magnetic resonance imaging (MRI) are routinely used to identify and evaluate osteochondritis dissecans lesions of the knee, MRI is often the imaging modality of choice and has been recommended as a technique to follow the healing response and degree of revascularization of the lesion 6,7. Osteochondritis dissecans. For determining the best treatment for osteochondritis dissecans (OCD) of the humeral capitellum, it is important to clarify whether the lesions are stable or unstable. Orthop J Sports Med . MRI classification of juvenile osteochondritis dissecans lesions Hefti F, Beguiristain J, Krauspe R, et al. Osteochondritis dissecans is generally diagnosed by conventional radiology. Its therapy is determined by the stage of the lesion and MRI will become the method of choice for staging. Using radio waves and a strong magnetic field, an MRI can provide detailed images of both hard and soft tissues, including the bone and cartilage. Am J Sports Med. 2012 Sep 26. . J Bone Joint Surg Am 1996;78:439-56. 11 Imaging of Osteochondritis Dissecans Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society. 13 , 15 , 16 Case contributed by Dr Vinay Shah. 11 MRI of Pediatric Patients: Part 2, Normal Variants and Abnormalities of the Knee 2018 Sep. 6 (9):2325967118794620. 1. 94, No. 5. 4. We define unstable OCD lesions as those with fragments that can be displaced by intraoperative probing. 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