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osteochondritis dissecans radiology

2005 May. 11 (2):129-136. J Bone Joint Surg [Am]. 1980. American Academy of Orthopaedic Surgeons clinical practice guideline on: the diagnosis and treatment of osteochondritis dissecans. 1995 May-Jun. Bachmann G, Jurgensen I, Siaplaouras J. 1981 Jul-Aug. (158):59-69. Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. Knee Osteochondritis Dissecans. [Medline]. Schenck RC Jr, Athanasiou KA, Constantinides G. A biomechanical analysis of articular cartilage of the human elbow and a potential relationship to osteochondritis dissecans. [4, 48, 49, 50, 51, 52, 53, 54], Occasionally, OCD of the tarsal navicular (see the images below) is seen on ankle radiographs. 2020 Aug;12(4):284-293. doi: 10.1177/1758573218821151. 2012 Jun. World J Orthop. 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). Jacobs JC Jr, Archibald-Seiffer N, Grimm NL, Carey JL, Shea KG. [Medline]. [Medline]. Osteochondritis dissecans of the femoral head in children and adolescents: a report of 17 cases. Early findings include subtle flattening or indistinct radiolucency about the cortical surface. AJR Am J Roentgenol. The cause of this lesion remains elusive. 89718-overview 2012 Apr. J Pediatr Orthop. Discrepancy between morphological findings in juvenile osteochondritis dissecans (OCD): a comparison of magnetic resonance imaging (MRI) and arthroscopy. 1981 Jul-Aug. (158):28-32. [4, 5, 6, 7, 8, 9]  Plain radiographs are limited in the ability to determine the stability of OCD lesions. Evaluation and treatment of osteochondritis dissecans lesions of the knee. [11, 12, 9]  The shortcomings of CT are applied radiation, especially in pediatric patients, and lack of cartilage visualization. Knee Surg Sports Traumatol Arthrosc. Am J Sports Med. [Medline]. 2015 Feb. 43 (2):303-9. Am J Sports Med. Filardo G, Andriolo L, Soler F, Berruto M, Ferrua P, Verdonk P, Rongieras F, Crawford DC. Effectiveness of ultrasonography screening and risk factor analysis of capitellar osteochondritis dissecans in adolescent baseball players. Radiography of the elbow for evaluation of patients with osteochondritis dissecans of the capitellum. AJR Am J Roentgenol. 6th ed. Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME, Raikin SM. Copyright © 2016. [Guideline] Chambers HG, Shea KG, Anderson AF, et al. Epub 2019 Jan 16. It is defined as a localized fragmentation of bone overlying the capitellum cartilage. Osteochondritis dissecans (OCD) most commonly affects the knee. Accuracy was 53% when reports addressed stability. Osteochondritis dissecans of the humeral head. Am J Sports Med. Bauer M, Jonsson K, Linden B. Osteochondritis dissecans of the ankle. Axial T2-weighted image of the ankle demonstrates subchondral bone marrow edema (arrowhead) in the proximal aspect of the tarsal navicular.  |  [Medline]. Mortise view of the ankle demonstrates a linear calcified loose body (arrowhead) in the talofibular joint and lucency in the lateral talar dome (arrow). Three-Dimensional Quantitative Magnetic Resonance Imaging of Epiphyseal Cartilage Vascularity Using Vessel Image Features: New Insights into Juvenile Osteochondritis Dissecans. 2007 Oct. 36(10):929-35. Weiss JM, Shea KG, Jacobs JC Jr, Cannamela PC, Becker I, Portman M, et al. [Medline]. Zbojniewicz AM, Laor T. Imaging of osteochondritis dissecans. 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. [16, 39, 46, 69, 70, 17, 18, 15, 19, 20, 21], T1-weighted sequences allow a detailed analysis of the bone signal. Yang TH, Lee YY, Huang CC, Huang YC, Chen PC, Hsu CH, et al. 2007 Oct-Nov. 27(7):821-5. 2014 Aug. 42 (8):1963-71. Stoffelen D, Renson L, Fabry G. Osteochondritis dissecans of the acetabulum. Hamada S, Hamada M, Nishiue S. Osteochondritis dissecans of the humeral head. 2004 Mar-Apr. [Guideline] Griffith JF, Lau DT, Yeung DK, Wong MW. 1947603519828434. [Medline]. Drawing of osteochondritis dissecans of the capitellum with a slightly displaced fragment. [Medline]. Joints. Joint Bone Spine. Felix S Chew, MD, MBA, MEd Professor, Department of Radiology, Vice Chairman for Academic Innovation, Section Head of Musculoskeletal Radiology, University of Washington School of Medicine Cheng MS, Ferkel RD, Applegate GR. Clin Orthop. It occurs when a small segment of bone begins to separate from its surrounding region … Linden B, Nilsson BE. Blood vessels within the epiphysis are incompetent because of thrombosis or microfractures of the trabeculae, which results in poor healing. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzkyMzk2LW92ZXJ2aWV3. 2016 Apr;24(4):1259-64. doi: 10.1007/s00167-015-3724-3. Bui-Mansfield LT, Lenchik L, Rogers LF. Radiographic findings correspond with arthroscopic staging in 56% of patients, because fibrosis may provide stability in osseous separation. 2008 Apr. Diseases & Conditions, 2001 In the first stage (acute injury), thickened and edematous intra-articular and periarticular soft tissues are observed. [Medline]. As the process progresses, more pronounced contour abnormalities, fragmentation and density changes (both lucency and sclerosis) become evident. Arthroscopic images were evaluated by two orthopedic surgeons in consensus. 2007 Feb. 28(2):154-61. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. Detterline AJ, Goldstein JL, Rue JP, Bach BR Jr. To diagnose osteochondritis dissecans, your orthopaedic specialist may request X-rays and an MRI … [Medline]. For a general discussion of osteochondritis dissecans … Mirror image osteochondral defects of the talus and distal tibia. Ann Biomed Eng. Results: Ultrasound in sports medicine. [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. AJR Am J Roentgenol. [Medline]. [Medline]. The Anderson MRI classification of osteochondral lesions of the talus is as follows Debeer P, Brys P. Osteochondritis dissecans of the humeral head: clinical and radiological findings. [Medline]. Osteochondrosis of the humeral capitellum. On conventional radiographs, osteochondral lesions may appear normal. [Medline]. Orthop Traumatol Surg Res. A preliminary report. 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%. 2006 Jul. 38 (5):e296-e299. High-resolution MR imaging of talar osteochondral lesions with new classification. Acta Orthop Scand. 2018 May. Radiology. Note the fluid in the subacromial/subdeltoid bursa and the supraspinatus tendon tear. However, this complication cannot be predicted during the early stages of the Legg-Calvé-Perthes process and may present years later. 1988. Although it can occur from childhood through adult life, the majority of patients are 10 to 20 years of … February 1995. OCD of the scaphoid has been observed in bakers, boxers, pelota players, acrobats, and pneumatic drill workers, all of whom are subjected to repeated minor trauma of the wrist. Magnetic Resonance Imaging Staging to Evaluate the Stability of Capitellar Osteochondritis Dissecans Lesions. This trauma was produced by the action of the head of the … 1981 Jul-Aug. (158):33-40. Nguyen JC, Degnan AJ, Barrera CA, Hee TP, Ganley TJ, Kijowski R. Osteochondritis Dissecans of the Elbow in Children: MRI Findings of Instability. Osteochondritis dissecans of the tarsal navicular bone: imaging findings in four patients. 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 … J Am Acad Orthop Surg. The OCD criteria of the ICRS were applied to arthroscopy and imaging interpretations. 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. OCD is limited to the articular epiphysis. 81 (6):1306-10. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Conclusions: Knee Surg Sports Traumatol Arthrosc. COVID-19 is an emerging, rapidly evolving situation. Acta Radiol. 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). 1995 Jul. Osteochondritis dissecans … In one study, sonographic assessment of OCD of the humeral capitellum agreed with radiographic assessment in 23 of 27 patients (85%), MRI assessment in 9 of 10 (90%), and surgical findings in 14 of 15 (93%). Often, the adjacent metaphysis reveals mild osteoporosis resulting from active hyperemia of the metaphysis. It is hypothesized that the classification system of the International Cartilage Repair Society (ICRS) will allow for improved assessment of lesion grade and stability in OCD. The sonographic appearance of OCD of the capitellum is as follows: stable—localized, subchondral bony flattening and normal articular surface; stable—lesion with nondisplaced osteochondral fragment; unstable—capitellar osteochondral defect with loose intra-articular fragment; unstable—lesion with slightly displaced osteochondral fragment. Ishibe M, Ogino T, Sato Y. Osteochondritis dissecans of the distal radioulnar joint. AJR Am J Roentgenol. OCD usually causes pain during and after sports. This is a normal variant. Osteochondritis dissecans (OCD) is characterized by separation of an osteochondral fragment from the articular surface. 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. van den Ende KIM, Keijsers R, van den Bekerom MPJ, Eygendaal D. Imaging and classification of osteochondritis dissecans of the capitellum: X-ray, magnetic resonance imaging or computed tomography?. Omer GE Jr. Primary articular osteochondroses. [Medline]. 2009 Mar. 1):561-6. [Medline]. Preoperative Evaluation of the Grade and Stability of Osteochondritis Dissecans of the Knee by Magnetic Resonance Imaging. Wood JB, Klassen RA, Peterson HA. 2015 Jan;46(1):133-9. doi: 10.1016/j.ocl.2014.09.009. 2014 Aug;42(8):1972-7. doi: 10.1177/0363546514532604. 2005 May. 34 (5):266-71. [Medline]. Acta Radiol. 163(1):38-44. Ferkel RD, Sgaglione NA. J Shoulder Elbow Surg. Three-dimensional gradient echo sequences with fat suppression provide clear assessment of the cartilage and differentiate the epiphyseal cartilage from the surface cartilage  with a thin low signal line between the layers. [Medline]. 1994 Feb. (299):305-12. CT is obtained in the direct axial and coronal planes at 1.5-mm-slice thickness with sagittal reformations. OCD is observed in approximately 3% of adults who had Legg-Calvé-Perthes disease as children. Nofsinger C, Konin JG. [Medline]. Int Orthop. van Bergen CJ, van den Ende KI, Ten Brinke B, Eygendaal D. Osteochondritis dissecans of the capitellum in adolescents. Axial-gradient recall image reveals an osteochondral lesion in the anterior half of the glenoid. Articular epiphyses fail as a result of compression. CT is obtained in the direct axial and coronal planes at 1.5-mm-slice thickness with sagittal reformations (see the images below). This website also contains material copyrighted by 3rd parties. The patella is a less common site for osteochondritis dissecans (OCD) of the knee. 2005 Aug. 71(4):484-8. J Pediatr Orthop. Skeletal Radiol. 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. 1975 Jun. 2002 [Medline]. 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 MRI findings of osteochondritis dissecans of the capitellum with surgical correlation. 2020 Jan. [Medline]. 12(4):317-22. Classification and assessment of juvenile osteochondritis dissecans knee lesions. [39, 40, 8, 14, 41, 42, 24], The causes of OCD of the elbow are regarded as multifactorial; they include repetitive valgus stress applied to the poorly vascularized capitellum, vascular inflammation, and genetic factors. [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. 34(5):266-71. Epub 2014 May 9. [14] and Itsubo et al found 100% sensitivity and 80% specificity. AJR Am J Roentgenol. The purpose of this study was to investigate the performance of MRI criteria for predicting instability of osteochondritis dissecans (OCD) lesions of the elbow in children. 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. Role of magnetic resonance imaging and clinical criteria in predicting successful nonoperative treatment of osteochondritis dissecans in children. J Bone Joint Surg [Br]. 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). A joint is where two bones come together. Osteochondral fracture of the tarsal navicular is not as rare as previously reported in the radiologic literature. [Medline]. 21(2):106-15. Rationale and objectives: Radiographic findings can be subtle and, in some patients, may mimic Mueller-Weiss syndrome or stress fracture of the tarsal navicular. Osteochondral lesion of the talus: A radiologic and surgical comparison. The lack of cartilage visualization can be overcome by using intra-articular contrast material. … Zanon G, DI Vico G, Marullo M. Osteochondritis dissecans of the talus. MRI correlates best with surgical staging. 2019 Jun;27(6):1726-1738. doi: 10.1007/s00167-018-5316-5. Sagittal T2-weighted image of the knee reveals an articular defect (arrow) and subchondral bone marrow edema (arrowhead) in the medial tibial plateau. The Pritsch arthroscopic staging of osteochondral lesions of the talus is as follows [Medline]. Osteochondritis dissecans of the talar articular surface of the ankle joint has been well described. If you log out, you will be required to enter your username and password the next time you visit. Ultrasonography of osteochondritis dissecans of the knee. Oblique coronal T1-weighted image demonstrates a hypointense lesion in the inferior half of the glenoid. Anteroposterior radiograph of the knee 1 year after injury reveals an anterior cruciate ligament reconstruction (arrowheads) and lucency (arrow) in the lateral tibial plateau. Unstable osteochondritis dissecans … 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. 2005 Dec. 185(6):1453-9. Magnetic Resonance Imaging of Osteochondritis Dissecans: Validation Study for the ICRS Classification System In this paper, we utilize arthroscopy as the gold standard to determine if MRI can predict OCD … J Hand Surg [Am]. [Medline]. Comparison of sonography and MRI in the evaluation of stability of capitellar osteochondritis dissecans. Zanon G, DI Vico G, Marullo M. Osteochondritis dissecans of the knee. 17:1011. 2019 Dec 5;4(4):e0031.1-9. Jans LB, Ditchfield M, Anna G, Jaremko JL, Verstraete KL. Anderson IF, Crichton KJ, Grattan-Smith T. Osteochondral fractures of the dome of the talus. [32, 33, 34, 35, 36, 5, 10, 37, 13], T1-weighted sequences allow a detailed analysis of the bone signal. Therefore, the … Sagittal T1-weighted image of the ankle confirms osteochondritis dissecans of the tarsal navicular (arrowhead). When detectable, osteochondral lesions appear as lucencies in the articular epiphysis. 1959. A radiological and anatomical study of one case. [37], In the elbow joint, the most common site of OCD is the anterolateral aspect of the capitellum. 8(1):132-7. [Medline]. Sagittal T2-weighted image of the knee reveals subchondral bone marrow edema (white arrowhead) and an articular cartilage defect in the patella. 1976 Dec. 121(3 Pt. Diseases & Conditions, encoded search term (Osteochondritis Dissecans Imaging) and Osteochondritis Dissecans Imaging, Humeral Capitellum Osteochondritis Dissecans, Cartilage Injury in the Knee: Assessment and Treatment Options, Management of Articular Cartilage Defects in the Glenohumeral Joint, Proposed RA Guidelines: Maximize Methotrexate Before Switching, Gout Clinical Practice Guidelines (ACR, 2020), A Man With Stooped Posture and Mysterious Back and Neck Pain, Denosumab Favored Over Alendronate for BMD Protection in Glucocorticoid-Induced Osteoporosis, Treatment Sequence With Romosozumab Influences Osteoporosis Outcomes. Novel radiographic feature classification of knee osteochondritis dissecans: a multicenter reliability study. A completely detached fragment is a loose body. [62, 63, 64, 65], Staging classifications of osteochondral lesions have been described best in the talus. McCullough RW, Gandsman EJ, Litchman HE. [Medline]. Grades 2b, 4b, and 5 are classified as unstable lesions of variable severity. Elbow involvement in osteochondritis dissecans is rare. Skeletal Radiol. [Medline]. Lateral view of the ankle reveals loss of the sharp cortical line (arrowhead) in the posterior aspect of the tibial plafond. Many patients with OCD of the femoral capital epiphysis have a prior history of Legg-Calve-Perthes Disease. Prevalence and Clinical Characteristics of Osteochondritis Dissecans of the Humeral Capitellum Among Adolescent Baseball Players. J Bone Joint Surg Am. 18(6):395-6. 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. [Full Text]. [Medline]. Background: Evaluations of the stability of osteochondritis dissecans (OCD) lesions of the elbow using magnetic resonance imaging (MRI) have resulted in reports with variable accuracy. Osteochondritis dissecans complicating Legg-Perthes disease. Tarsal navicular OCD does not demonstrate the classic radiographic appearance of Mueller-Weiss syndrome, which includes comma-shaped deformity of the navicular resulting from collapse of the lateral portion of the bone, bipartite navicular resulting from fracture, or protrusion of portions of the bone or the entire navicular bone, medially or dorsally. Radiology. [16]   A short tau-inversion recovery sequence is the most sensitive. 1980 May. Ellermann JM, Ludwig KD, Nissi MJ, Johnson CP, Strupp JP, Wang L, Zbýň Š, Tóth F, Arendt E, Tompkins M, Shea K, Carlson CS. [27, 28]. [Medline]. Osteochondritis dissecans (OCD) is characterized by separation of an osteochondral fragment from the articular surface. MRI provides a more precise evaluation of the size of the lesion and structure of the overlying cartilage. [50, 55, 56, 57, 58], OCD rarely occurs in the shoulder joint, where it involves either the humeral head or the glenoid. [49]. [1, 2, 3]  Osteochondritis dissecans occurs in approximately 15 to 29 per 100,000 patients. Athanasiou KA, Niederauer GG, Schenck RC Jr. Biomechanical topography of human ankle cartilage. Arthroscopy 2011; 27:194. Sagittal reformatted image of the ankle reveals a nondisplaced osteochondral fragment. Maruyama M, Takahara M, Satake H. Diagnosis and treatment of osteochondritis dissecans of the humeral capitellum. 2018 Mar. The authors concluded from their findings that previously described MR imaging criteria for OCD instability have high specificity for adult but not juvenile lesions of the knee. Oblique, coronal T2-weighted image of the right shoulder demonstrates a developmental defect in the glenoid filled with fluid (arrowhead). In some cases, you or your doctor will be able to feel a loose fragment inside your joint. Roßbach BP, Paulus AC, Niethammer TR, Wegener V, Gülecyüz MF, Jansson V, Müller PE, Utzschneider S. Knee Surg Sports Traumatol Arthrosc.  |  Kijowski R, De Smet AA. 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. Ellermann J, Johnson CP, Wang L, Macalena JA, Nelson BJ, LaPrade RF. [Full Text]. [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. J Knee Surg. 2000 Feb. 174(2):411-5. … Curr Rev Musculoskelet Med. 2 (1):29-36. 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Arthroscopic correlation tissues are observed tibial articular surface … osteochondritis osteochondritis dissecans radiology of the sharp line. Oblique coronal T1-weighted image of the tarsal navicular bone: imaging findings in Juvenile dissecans... Childhood obesity is associated with osteochondritis dissecans of the literature ; 42 ( )... Dissecans … Background the name osteochondritis dissecans … osteochondritis dissecans of the femoral capital epiphysis a... Appear as lucencies in the hip T, Tachiiri H, Zhang C Poehling... 2B, 4b, and medio-inferior aspects of glenoid lesions appear as lucencies in the of...

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