Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects. We define unstable OCD lesions as those with fragments that can be displaced by intraoperative probing. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. Arthroscopic versus conservative treatment of osteochondritis dissecans of the knee: value of magnetic resonance imaging in therapy planning and follow-up. 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. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. 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. Diagnoses: Magnetic resonance imaging revealed a lateral trochlear OCD extending into the anterior lateral femoral condyle. A joint is where two bones come together. The case on the left is unstable for two reasons: - small cysts at the base of the lesion (red arrow) - even more … Osteochondritis dissecans usually develops in just one joint. [2] That process can lead to pain, loose body formation and joint effusion.[1] 5 Osteochondritis Dissecans of the knee: Value of MR Imaging in Determining Lesion Stability and the Presence of Articular Cartilage Defects. Bilateral Osteochondritis Dissecans of the Knee CAPT. 231 plays. Knee Surg Sports Traumatol Arthrosc. Kevin R. Stone, Biological Knee Reconstruction Annual Joint Preserving Meeting, Johns Hopkins 2004 ; Osteochondritis dissecans 1. When osteochondritis dissecans occurs elsewhere in the skeleton, it affects the bone on the convexity of the affected joint (e.g., talar dome, capitellum, head of first metatarsal) almost exclusively, with rare exceptions, such as the tibial plafond and the glenoid. An osteochondritis dissecans lesion in the knee is a condition that is caused by a reduction of blood flow to the end of a bone within the knee joint. Research in Osteochondritis of the Knee OCD Study Group of America. Osteochondritis dissecans. 2/24/2020. AJR; 1990; 155:549-553. The first sequence of MRI scans in a coronal scan. Hayes CW, Conway WF. 1 The condition is characterized by sterile osteonecrosis of the subchondral bone, which can lead to a spectrum of clinical symptoms, ranging from asymptomatic stable lesions to loose fragments causing locking and swelling. De Smet AA, Fisher DR, Graf BK, Lange RH. Etiology AJR; 1990; 155:549-553. 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). 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 is a disorder in which a fragment of cartilage and subchondral bone separates from an articular surface. Knee & Sports ⎪Osteochondritis Dissecans Orthobullets Team Knee & Sports - Osteochondritis Dissecans; Listen Now 23:49 min. OCD lesions occur when a segment of subchondral bone… The etiology is uncertain, although trauma and ischemia have been implicated. Osteochondritis Dissecans (OCD) of the knee is an acquired, reversible, idiopathic condition of the subchondral bone. [1] This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space. Red arrows point to osteochondral defect and bone edema on T1 and stir This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. 163(1):38-44. 14 year old girl with pain, swelling and inability to move right knee joint (J Orthopaedic Case Reports 2012;2:3) 26 year old woman with chronic ankle pain ( BMJ Case Rep 2009;Apr 14:2009 ) Treatment ... Advanced Radiology Services – Grand Rapids Phone: (616) 363 – 7272. Osteochondritis Dissecans. Evaluation of articular cartilage: radiographic and cross-sectional imaging techniques. The knee is most commonly affected, but the elbow and ankle may also be involved. R. H. Hermanson , M.C., A.U.S. With JOCD, there is a loosening of a piece of bone and the cartilage that covers it. Osteochondritis dissecans (OCD) is a localized process that affects the subchondral bone and can progress to the overlying articular cartilage. Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. The question for MRI is whether it is stable or unstable. Osteochondritis dissecans (OCD) of the knee is a well-recognized condition that affects children and adolescents. Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. The diagnosis Osteochondritis Dissecans is usually made on X-rays. Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. 1995 Jul. e pain, which had worsened following a collision with another player during a basketball game, resulting in episodes of locking. What to do when OCD fixation fails? OCD usually causes pain and swelling of the affected joint which catches and locks during movement. OSTEOCHONDRITIS DISSECANS OF THE KNEE A preliminary report H. E. GREGERSEN and 0. Personal blog / website. A comparison with conventional radiology and arthroscopy]. 1990 Sep; 155 (3):549–553. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. Radiology 2008; 248:571–578 [Google Scholar] 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. ObjectiveOsteochondral surgical procedures have been described for the treatment of unfixable osteochondritis dissecans (OCD), but only few of them have … (PMID: 11951196) [2] Hefti F, Beguiristain J, Krauspe R, Moller-Madsen … Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee With the vague clinical symptoms and signs of OCD, imaging plays a vital role in making the diagnosis and helping with the prognosis of OCD lesions. The condition can also occur in other joints, including the shoulder and hip. The articular cartilage surface may be intact or may be breached allowing communication of the joint fluid with the bone. The condition is bilateral in 20 to 30% of patients. [The staging of osteochondritis dissecans in the knee and ankle joints with MR tomography. The cause of this lesion remains elusive. For the same photo without the arrows, click here. This article… Knee Surg Sports Traumatol Arthrosc. Salvage of Large OCD Lesions: Articular Cartilage Paste Grafting Kevin R. Stone, MD CPMC Grand Rounds 2/13/2009 Stone Research Foundation 2. Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. Blue arrow points to crescentric lucency in the convex surface of the medial condyle of the knee. AJR Am J Roentgenol. Etiology relates to a subchondral fatigue fracture usually as a result of shearing, rotatory or tangentially aligned impaction forces. Normal hard bone is covered with a softer form of bone called cartilage at the joint surface. Osteochondritis dissecans is on the differential, but it is more often found in patients younger than 25 years old and located to a single condyle without affecting other parts of the joint. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. 2013 ;21(2):403-7. doi: 10.1007/s00167-012-1983-9 . ... Avoid activities that stress your joint, such as jumping and running if your knee is affected. What is osteochondritis dissecans (OCD)? The OCD lesion can remain in contact with the adjacent bone, maybe partially separated or completely separated. The cause is unknown. The cause is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Cause of a “locking knee” Osteochondritis dissecans. The osteochondral fragment is detached, yet not displaced from the medial femoral condyle, in keeping with grade III osteochondritis dissecans. 6 De Smet A. Radiology of Osteochondritis Dissecans. Interventions: Chondral fraying was observed along the margins of the OCD. 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