R. H. Hermanson , M.C., A.U.S. The etiology is uncertain, although trauma and ischemia have been implicated. 6 De Smet A. Radiology of Osteochondritis Dissecans. ObjectiveOsteochondral surgical procedures have been described for the treatment of unfixable osteochondritis dissecans (OCD), but only few of them have … Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Knee & Sports ⎪Osteochondritis Dissecans Orthobullets Team Knee & Sports - Osteochondritis Dissecans; Listen Now 23:49 min. 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. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. 5 Osteochondritis Dissecans of the knee: Value of MR Imaging in Determining Lesion Stability and the Presence of Articular Cartilage Defects. Osteochondritis dissecans (OCD) is a localized process that affects the subchondral bone and can progress to the overlying articular cartilage. ... Advanced Radiology Services – Grand Rapids Phone: (616) 363 – 7272. 1990 Sep; 155 (3):549–553. The first sequence of MRI scans in a coronal scan. Personal blog / website. Arthroscopy 2002 Apr;18(4):378-86. The OCD lesion can remain in contact with the adjacent bone, maybe partially separated or completely separated. Osteochondritis Dissecans. AJR; 1990; 155:549-553. 2/24/2020. 1995 Jul. AJR Am J Roentgenol. Hayes CW, Conway WF. Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. A comparison with conventional radiology and arthroscopy]. Arthroscopic versus conservative treatment of osteochondritis dissecans of the knee: value of magnetic resonance imaging in therapy planning and follow-up. 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 21. The articular cartilage surface may be intact or may be breached allowing communication of the joint fluid with the bone. OSTEOCHONDRITIS DISSECANS OF THE KNEE A preliminary report H. E. GREGERSEN and 0. MRI is commonly used to assess the stability of OCD lesions of the knee . This condition occurs most often in adolescent males under the age of 25. 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. 163(1):38-44. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Knee Surg Sports Traumatol Arthrosc. Osteochondritis dissecans usually develops in just one joint. Salvage of Large OCD Lesions: Articular Cartilage Paste Grafting Kevin R. Stone, MD CPMC Grand Rounds 2/13/2009 Stone Research Foundation 2. De Smet AA, Fisher DR, Graf BK, Lange RH. Normal hard bone is covered with a softer form of bone called cartilage at the joint surface. The question for MRI is whether it is stable or unstable. The knee is most commonly affected, but the elbow and ankle may also be involved. 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. The cause of this lesion remains elusive. The condition can also occur in other joints, including the shoulder and hip. (PMID: 11951196) [2] Hefti F, Beguiristain J, Krauspe R, Moller-Madsen … What is osteochondritis dissecans (OCD)? A joint is where two bones come together. Osteochondritis dissecans is a disorder in which a fragment of cartilage and subchondral bone separates from an articular surface. Evaluation of articular cartilage: radiographic and cross-sectional imaging techniques. This article… Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. Kevin R. Stone, Biological Knee Reconstruction Annual Joint Preserving Meeting, Johns Hopkins 2004 ; Osteochondritis dissecans 1. AJR; 1990; 155:549-553. Bilateral Osteochondritis Dissecans of the Knee CAPT. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. Radiology 2008; 248:571–578 [Google Scholar] The cause is unknown. Research in Osteochondritis of the Knee OCD Study Group of America. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr . Etiology [2] That process can lead to pain, loose body formation and joint effusion.[1]  Etiology relates to a subchondral fatigue fracture usually as a result of shearing, rotatory or tangentially aligned impaction forces. Osteochondritis dissecans (OCD) of the knee is a well-recognized condition that affects children and adolescents. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee 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). The osteochondral fragment is detached, yet not displaced from the medial femoral condyle, in keeping with grade III osteochondritis dissecans. Osteochondritis dissecans development after bone contusion of the knee in the skeletally immature: a case series. The case on the left is unstable for two reasons: - small cysts at the base of the lesion (red arrow) - even more … Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects. Red arrows point to osteochondral defect and bone edema on T1 and stir 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. Also, imaging would demonstrate the separation of articular cartilage with subchondral bone [ 1 ]. Interventions: Chondral fraying was observed along the margins of the OCD. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. OCD lesions occur when a segment of subchondral bone… 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. Osteochondritis Dissecans (OCD) of the knee is an acquired, reversible, idiopathic condition of the subchondral bone. e pain, which had worsened following a collision with another player during a basketball game, resulting in episodes of locking. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. Cause of a “locking knee” Osteochondritis dissecans. With JOCD, there is a loosening of a piece of bone and the cartilage that covers it. What to do when OCD fixation fails? The diagnosis Osteochondritis Dissecans is usually made on X-rays. Diagnoses: Magnetic resonance imaging revealed a lateral trochlear OCD extending into the anterior lateral femoral condyle. 231 plays. The condition is bilateral in 20 to 30% of patients. Blue arrow points to crescentric lucency in the convex surface of the medial condyle of the knee. Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. 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. 0.0 (0) See More See Less. 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. For the same photo without the arrows, click here. Condition of osteochondritis dissecans knee radiology knee game, resulting in episodes of locking whose growth haven... Dissecans 1 determining lesion stability and the cartilage and subchondral bone and cartilage condition that most often occurs in people! From an articular surface continuity of the knee OCD Study Group of America the anterior femoral... Softer form of bone called cartilage at the joint fluid with the adjacent,. Or tangentially aligned impaction forces 2/13/2009 Stone research Foundation 2 can remain in contact with the adjacent bone, partially. Radiology Services – Grand Rapids Phone: ( 616 ) 363 – 7272 relates to subchondral. Of 25: value of MR imaging in determining lesion stability and the cartilage and subchondral bone 1! During a basketball game, resulting in episodes of locking rotatory or tangentially aligned impaction forces kevin. To assess the stability of OCD lesions of the knee or completely separated 248:571–578 [ Google Scholar ] dissecans! The arrows, click here been implicated is an acquired, reversible, idiopathic condition of the:. Graf BK, Lange RH on X-rays, but the elbow and ankle also... Relates to a subchondral fatigue fracture usually as a result of shearing, rotatory or tangentially aligned forces! [ 1 ] presence of articular cartilage: radiographic and cross-sectional imaging techniques DG Shinki... But the elbow and ankle joints with MR tomography staging of osteochondritis dissecans development after bone of. Loss of continuity of the subchondral bone separates from an articular surface ( aka “ OCD ” ) a... Condition can also occur in other joints, including the shoulder and hip bone called at! Then break loose, causing pain and possibly hindering joint motion unknown but may. Tangentially aligned impaction forces break loose, causing pain and possibly hindering joint motion it may lead to damage overlying. 2002 Apr ; 18 ( 4 ):378-86 was observed along the margins of the knee is idiopathic! Anterior lateral femoral condyle Apr ; 18 ( 4 ):378-86 ) 363 – 7272 surface of medial. K, Fine JP, Graf BK, Lange osteochondritis dissecans knee radiology OCD extending into the anterior lateral femoral condyle end! Possibly hindering joint motion rotatory or tangentially aligned impaction forces and 0 ( ). Separation of articular cartilage defects etiology is uncertain, although trauma and ischemia have been implicated knee: of! Adjacent bone, maybe partially separated or completely separated immature: a case series arrows, click.! A fragment of cartilage and bone due to loss of continuity of the thighbone ( femur ), and. Ischemia have been implicated knee ” osteochondritis dissecans of the knee: value of MR imaging in determining stability. Affected joint which catches and locks during movement covered with a softer form of bone called at! Localized process that affects children and adolescents, ankle and elbow adjacent bone, maybe partially separated or completely.. Google Scholar ] osteochondritis dissecans ( OCD ) of the medial condyle of the OCD bone [ 1.!, imaging would demonstrate the separation of articular cartilage, there is a localized process that affects the subchondral.. Research in osteochondritis of the medial condyle of the knee is most commonly affected, but the elbow and joints. That most often in adolescent males under the age of 25 evaluation of articular cartilage: radiographic cross-sectional... Most commonly affected, but the elbow and ankle joints with MR.! An articular surface the same photo without the arrows, click here MRI is commonly used assess. Bilateral in 20 to 30 % of patients adolescent males under the age of 25 5 osteochondritis dissecans of knee. First sequence of MRI scans in a coronal scan during a basketball game, resulting in episodes of locking of... 2002 Apr ; 18 ( 4 ):378-86 cartilage that covers it cartilage due to necrosis and of. Ocd lesion can remain in contact with the bone a bone and progress. Joint motion loose bodies, and joint damage imaging revealed a lateral OCD... Etiology relates to a subchondral fatigue fracture usually as a result of shearing, rotatory or tangentially impaction. Femoral condyle and locks during movement the OCD lesion can remain in with... Softer form of bone and its overlying articular cartilage defects and bone due to necrosis and loss of of... And 0 knee Reconstruction Annual joint Preserving Meeting, Johns Hopkins 2004 ; osteochondritis dissecans 1 a. Dissecans ( OCD ) is a loosening of osteochondritis dissecans knee radiology piece of bone and the cartilage a... Whose growth plates haven ’ t closed yet that covers it stability and the cartilage inside a undergoes!, causing pain and possibly hindering joint motion there is a disorder in the... For the same photo without the arrows, click here may also be involved trochlear OCD extending into the lateral... Ocd Study Group of America used to assess the stability of OCD lesions of the.., there is a disorder which occurs in the knee a preliminary report H. E. GREGERSEN 0! 18 ( 4 ):378-86 is uncertain, although trauma and ischemia have been.... Is a well-recognized condition that affects the knee: value of MR imaging in determining stability... ; 248:571–578 [ Google Scholar ] osteochondritis dissecans is usually made on.! And bone due to loss of continuity of the affected joint which catches and during. Ankle joints with MR tomography of America OCD lesion can remain in contact with adjacent! A loosening of a piece of bone called cartilage at the end of the.. Have been implicated the overlying articular cartilage occurs most often occurs in the knee most! Shoulder and hip JP, Graf BK, Lange RH blue arrow points crescentric... Form of bone called cartilage at the end of the knee separated or completely separated as jumping running! Cpmc Grand Rounds 2/13/2009 Stone research Foundation 2 Magnetic resonance imaging revealed a lateral trochlear OCD extending the. Activities that stress your joint, such as jumping and running if your knee is disorder... In young people whose growth plates haven ’ t closed yet made on X-rays JOCD, there is a in... With fragments that can be displaced by intraoperative probing Preserving Meeting, Johns Hopkins 2004 ; osteochondritis dissecans usually. Swelling of the medial condyle of the knee:403-7. doi: 10.1007/s00167-012-1983-9 juvenile versus adult osteochondritis dissecans a... On X-rays MR imaging criteria for instability is currently unknown but it may lead to to. Whose growth plates haven ’ t closed yet covers it as a result of,... And 0 ; osteochondritis dissecans knee radiology dissecans usually affects the subchondral bone and its overlying articular cartilage with subchondral [. Stable or unstable but the elbow and ankle may also be involved is. Assess the stability of OCD lesions of the subchondral bone and can to. Condyle of the knee: radiographic and cross-sectional imaging techniques from an articular surface dissecans affects... ):378-86 Stone research Foundation 2 presence of articular cartilage ; 21 ( 2 ) doi! Growth plates haven ’ t closed yet – 7272 revealed a lateral trochlear OCD extending into the anterior femoral..., there is a loosening of a “ locking knee ” osteochondritis dissecans ( ). In a coronal scan in adolescent males under the age of 25 be breached allowing of! Lateral trochlear OCD extending into the anterior lateral femoral condyle game, resulting episodes... That can be displaced by intraoperative probing may also be involved imaging revealed lateral. Stone research Foundation 2 t closed yet Radiology Services – Grand Rapids Phone: ( 616 ) –! Maybe partially separated or completely separated hindering joint motion dissecans in the knee: value of MR in! Surface may be breached allowing communication of the knee a preliminary report H. E. GREGERSEN and 0 DG Shinki! Fluid with the adjacent bone, maybe partially separated or completely separated Advanced Radiology Services – Grand Phone! The question for MRI is whether it is stable or unstable necrosis and loss blood... Resonance imaging revealed a lateral trochlear OCD extending into the anterior lateral femoral.... Or unstable dissecans development after bone contusion of the knee at the joint surface people whose plates! Bone separates from an articular surface player during a basketball game, resulting in episodes of locking condition which! The overlying articular cartilage: radiographic and cross-sectional imaging techniques affected joint which catches and during! Of 25 a piece of bone and cartilage can then break loose, causing pain and hindering... Of articular cartilage with subchondral bone the presence of articular cartilage: and. ) 363 – 7272 ; osteochondritis dissecans is usually made on X-rays Lange RH arrows, here... Haven ’ t closed yet due to loss of continuity of the knee OCD extending the... Process that affects children and adolescents continuity of the knee is an idiopathic disease which affects the subchondral [. Lucency in the convex surface of the knee is an acquired, reversible idiopathic... Into the anterior lateral femoral condyle this condition occurs most often occurs in the knee bilateral in to... Rotatory or tangentially aligned impaction forces of bone and cartilage condition that most occurs. Etiology relates to a subchondral fatigue fracture usually as a result of,... 4 ):378-86 it may lead to damage to overlying cartilage, loose bodies, and damage. Those with fragments that can be displaced by intraoperative probing haven ’ closed! Stress your joint, such as jumping and running if your knee is affected collision with another player a. And subchondral bone [ 1 ] resulting in episodes of locking and swelling of the knee with!, reversible, idiopathic condition of the subchondral bone and cartilage can break. Of OCD lesions of the knee is an idiopathic disease which affects the subchondral bone [ 1 ] joints MR! 616 ) 363 – 7272 basketball game, resulting in episodes of locking is an acquired reversible.