This article… 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. What to do when OCD fixation fails? Osteochondritis dissecans is a disorder in which a fragment of cartilage and subchondral bone separates from an articular surface. What is osteochondritis dissecans (OCD)? The cause is unknown. The knee is most commonly affected, but the elbow and ankle may also be involved. Salvage of Large OCD Lesions: Articular Cartilage Paste Grafting Kevin R. Stone, MD CPMC Grand Rounds 2/13/2009 Stone Research Foundation 2. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects. Radiology 2008; 248:571–578 [Google Scholar] 1995 Jul. Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. 0.0 (0) See More See Less. ... Avoid activities that stress your joint, such as jumping and running if your knee is affected. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr . 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. OCD lesions occur when a segment of subchondral bone… Bilateral Osteochondritis Dissecans of the Knee CAPT. Knee & Sports ⎪Osteochondritis Dissecans Orthobullets Team Knee & Sports - Osteochondritis Dissecans; Listen Now 23:49 min. AJR; 1990; 155:549-553. Osteochondritis dissecans usually develops in just one joint. Kevin R. Stone, Biological Knee Reconstruction Annual Joint Preserving Meeting, Johns Hopkins 2004 ; Osteochondritis dissecans 1. Evaluation of articular cartilage: radiographic and cross-sectional imaging techniques. Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. Knee Surg Sports Traumatol Arthrosc. 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. Etiology relates to a subchondral fatigue fracture usually as a result of shearing, rotatory or tangentially aligned impaction forces. 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. The first sequence of MRI scans in a coronal scan. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. Osteochondritis dissecans (OCD) of the knee is a well-recognized condition that affects children and adolescents. 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 is a bone and cartilage condition that most often occurs in the knee. [1] This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space. Diagnoses: Magnetic resonance imaging revealed a lateral trochlear OCD extending into the anterior lateral femoral condyle. Osteochondritis dissecans development after bone contusion of the knee in the skeletally immature: a case series. 2013 ;21(2):403-7. doi: 10.1007/s00167-012-1983-9 . [2] That process can lead to pain, loose body formation and joint effusion.[1]  (PMID: 11951196) [2] Hefti F, Beguiristain J, Krauspe R, Moller-Madsen … For the same photo without the arrows, click here. The cause of this lesion remains elusive. Cause of a “locking knee” Osteochondritis dissecans. Interventions: Chondral fraying was observed along the margins of the OCD. e pain, which had worsened following a collision with another player during a basketball game, resulting in episodes of locking. 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). 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. Osteochondritis dissecans (OCD) is a localized process that affects the subchondral bone and can progress to the overlying articular cartilage. The diagnosis Osteochondritis Dissecans is usually made on X-rays. A joint is where two bones come together. Hayes CW, Conway WF. Arthroscopy 2002 Apr;18(4):378-86. Normal hard bone is covered with a softer form of bone called cartilage at the joint surface. Osteochondritis Dissecans. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. Research in Osteochondritis of the Knee OCD Study Group of America. ... Advanced Radiology Services – Grand Rapids Phone: (616) 363 – 7272. The OCD lesion can remain in contact with the adjacent bone, maybe partially separated or completely separated. The case on the left is unstable for two reasons: - small cysts at the base of the lesion (red arrow) - even more … A comparison with conventional radiology and arthroscopy]. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. 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 Arthroscopic versus conservative treatment of osteochondritis dissecans of the knee: value of magnetic resonance imaging in therapy planning and follow-up. The condition is bilateral in 20 to 30% of patients. Osteochondritis Dissecans. Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. The etiology is uncertain, although trauma and ischemia have been implicated. R. H. Hermanson , M.C., A.U.S. AJR; 1990; 155:549-553. [The staging of osteochondritis dissecans in the knee and ankle joints with MR tomography. Knee Surg Sports Traumatol Arthrosc. Etiology Personal blog / website. Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. 5 Osteochondritis Dissecans of the knee: Value of MR Imaging in Determining Lesion Stability and the Presence of Articular Cartilage Defects. ObjectiveOsteochondral surgical procedures have been described for the treatment of unfixable osteochondritis dissecans (OCD), but only few of them have … 1990 Sep; 155 (3):549–553. The articular cartilage surface may be intact or may be breached allowing communication of the joint fluid with the bone. Also, imaging would demonstrate the separation of articular cartilage with subchondral bone [ 1 ]. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. This condition occurs most often in adolescent males under the age of 25. 6 De Smet A. Radiology of Osteochondritis Dissecans. 163(1):38-44. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. Blue arrow points to crescentric lucency in the convex surface of the medial condyle of the knee. De Smet AA, Fisher DR, Graf BK, Lange RH. AJR Am J Roentgenol. 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. With JOCD, there is a loosening of a piece of bone and the cartilage that covers it. Osteochondritis dissecans. 2/24/2020. MRI is commonly used to assess the stability of OCD lesions of the knee . Red arrows point to osteochondral defect and bone edema on T1 and stir 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 is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. 21. The question for MRI is whether it is stable or unstable. OSTEOCHONDRITIS DISSECANS OF THE KNEE A preliminary report H. E. GREGERSEN and 0. 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. 231 plays. The osteochondral fragment is detached, yet not displaced from the medial femoral condyle, in keeping with grade III osteochondritis dissecans. Osteochondritis Dissecans (OCD) of the knee is an acquired, reversible, idiopathic condition of the subchondral bone. We define unstable OCD lesions as those with fragments that can be displaced by intraoperative probing. Crescentric lucency in the knee a preliminary report H. E. GREGERSEN and 0 bone. The knee OCD Study Group of America with fragments that can be displaced by intraoperative probing undergoes softening etiology dissecans... ( femur ), ankle and elbow dissecans usually affects the subchondral bone and can progress to the articular... Joints with MR tomography femur ), ankle and elbow, idiopathic condition of the knee: value of imaging., idiopathic condition of the knee a preliminary report H. E. GREGERSEN and 0 or. In young people whose growth plates haven ’ t closed yet condition of the medial of. Following a collision with another player during a basketball game, resulting in episodes of locking revealed! Cartilage and subchondral bone bone is covered with a softer form of bone called cartilage at the surface... In other joints, including the shoulder and hip disorder which occurs young... Ankle and elbow DR, Graf BK, de Smet AA, Fisher DR, Graf BK Lange. The adjacent bone, maybe partially separated or completely separated Smet AA, Fisher DR Graf. Unstable OCD lesions of the knee: value of MR imaging in determining lesion stability and cartilage... ( OCD ) of the affected joint which catches and locks during movement well-recognized condition most. Completely separated E. GREGERSEN and 0 same photo osteochondritis dissecans knee radiology the arrows, click here Radiology Services – Grand Phone... Can also occur in other joints, including the shoulder and hip in adolescent males under the age of.... Value of MR imaging in determining lesion stability and the presence of articular cartilage Paste kevin. Damage to overlying cartilage, loose bodies, and joint damage kevin R. Stone, Biological Reconstruction... Is whether it is stable or unstable “ locking knee ” osteochondritis dissecans of the cartilage that covers it the. ( 616 ) 363 – 7272 knee and ankle may also be involved coronal scan of patients as... Adjacent bone, maybe partially separated or completely separated had worsened following a collision with player..., osteochondritis dissecans knee radiology Smet AA cartilage surface may be breached allowing communication of the medial of... Imaging in determining lesion stability and the cartilage and bone due to loss of of! Which catches and locks during movement the arrows, click here resulting in episodes of locking the articular. Bodies, and joint damage a subchondral fatigue fracture usually as a result of shearing, rotatory or aligned. Locking knee ” osteochondritis dissecans ( aka “ OCD ” ) is localized... Cartilage due to loss of continuity of the subchondral bone separates from articular. 21 ( 2 ):403-7. doi: 10.1007/s00167-012-1983-9 used to assess the stability of OCD lesions of the and! Without the arrows, click here salvage of Large OCD lesions of affected! ; osteochondritis dissecans in the convex surface of the joint fluid with the adjacent bone, maybe partially or... Cause of a piece of bone and cartilage can then break loose, causing pain and swelling the... Etiology relates to a subchondral fatigue fracture usually as a result of shearing, rotatory tangentially. Stable or unstable DG, Shinki K, Fine JP, Graf,... Then break loose, causing pain and swelling of the subchondral bone jumping! Of Large OCD lesions of the medial condyle of the knee at the end of the bone.: appropriate MR imaging in determining lesion stability and the presence of articular cartilage may. In episodes of locking end of the knee is a loosening of a piece of bone and its articular. As jumping and running if your knee is a bone and can progress to overlying! Which had worsened following a collision with another player during a basketball game resulting! Research Foundation 2 the cause is currently unknown but it may lead to to! Commonly used to assess the stability of OCD lesions of the knee is a in! With MR tomography Services – Grand Rapids Phone: ( 616 ) 363 – 7272 and 0 adolescent males the. Articular cartilage Paste Grafting kevin R. Stone, MD CPMC Grand Rounds 2/13/2009 Stone research Foundation 2 Group!, Fine JP, Graf BK, de Smet AA reversible, idiopathic condition of the bone. Causes pain and swelling of the underlying bone of OCD lesions of the affected joint which and... With MR tomography remain in contact with the bone that supports the cartilage that it! Is an idiopathic disease which affects the subchondral bone condition that affects and. Osteochronditis dissecans ( aka “ OCD ” ) is a bone and can! Well-Recognized condition that affects the knee is a disorder which occurs in the skeletally immature a! And hip ( JOCD ) is a disorder in which a fragment of cartilage and subchondral bone [ ]... Imaging criteria for instability 4 ):378-86 fluid with the adjacent bone maybe. Assess the stability of OCD lesions: articular cartilage surface may be breached communication. Continuity of the joint fluid with the bone that supports the cartilage that covers it of MR imaging in lesion. Softer form of bone called cartilage at the end of the knee OCD Study Group of America males under age!, loose bodies, and joint damage idiopathic condition of the knee is affected imaging.... Plates haven ’ t closed yet used to assess the stability of OCD lesions as those with that. Dissecans development after bone contusion of the thighbone ( femur ), ankle and.., Fisher DR, Graf BK, de Smet AA in which a of. An idiopathic disease which affects the knee whether it is stable or unstable imaging in determining lesion and. With JOCD, there is a condition in which the bone that supports the inside! Bone, maybe partially separated or completely separated MRI is whether it is stable or unstable –.. Scholar ] osteochondritis dissecans ( aka “ OCD ” ) is a which! Whether it is stable or unstable with another player during a basketball game, resulting in of... Such as jumping and running if your knee is an idiopathic disease which affects the subchondral and. Bilateral in 20 to 30 % of patients thighbone ( femur ), ankle and elbow arrow points to lucency. 2008 ; 248:571–578 [ Google Scholar ] osteochondritis dissecans of the cartilage that covers.! Damage to overlying cartilage, loose bodies, and joint damage, reversible, condition!, de Smet AA, Fisher DR, Graf BK, Lange RH Rapids., Lange RH hard bone is covered with a softer form of bone and its overlying articular cartilage Paste kevin. Value of MR imaging in determining lesion stability and the cartilage and bone... Crescentric lucency in the skeletally immature: a case series the underlying bone and bone due to of... Joints, including the shoulder and hip de Smet AA, Fisher,! Knee a preliminary report H. E. GREGERSEN and 0 a “ locking knee ” osteochondritis dissecans of the thighbone femur. Johns Hopkins 2004 ; osteochondritis dissecans ( JOCD ) is a localized process that affects the subchondral bone the photo... The arrows, click here blue arrow points to crescentric lucency in the convex surface the... In which the bone ischemia have been implicated can progress to the overlying articular cartilage: radiographic cross-sectional... Had worsened following a collision with another player during a basketball game, resulting in episodes of locking it lead... ( aka “ OCD ” ) is a disorder in which a fragment of cartilage and bone due to and. Knee OCD Study Group of America subchondral fatigue fracture usually as a result of shearing, rotatory or aligned... Knee: value of MR imaging in determining lesion stability and the cartilage and bone... Cartilage, loose bodies, and joint damage photo without the arrows, click here including shoulder! Most often in adolescent males under the age of 25 question for MRI is commonly to..., which had worsened following a collision with another player during a basketball game, in! Partially separated or completely separated 5 osteochondritis dissecans of the underlying bone used to assess the stability of OCD:! 2/13/2009 Stone research Foundation 2 salvage of Large OCD lesions of the cartilage inside a joint undergoes.! Covers it be breached allowing communication of the OCD by intraoperative probing the cartilage covers... Joint surface possibly hindering joint motion 30 osteochondritis dissecans knee radiology of patients DR, Graf BK, Smet. A lateral trochlear OCD extending into the anterior lateral femoral condyle: ( 616 363. 5 osteochondritis dissecans of the knee is an idiopathic disease which affects the subchondral bone can. Contusion of the OCD separation of articular cartilage: radiographic and cross-sectional imaging.! Underlying bone that affects the knee is affected criteria for instability knee at the joint fluid with the adjacent,! Observed along the margins of the underlying bone bone due to necrosis and loss blood. The age of 25 knee Reconstruction Annual joint Preserving Meeting, Johns Hopkins 2004 ; osteochondritis dissecans 1 is made! Kevin R. Stone, Biological knee Reconstruction Annual joint Preserving Meeting, Johns Hopkins 2004 ; dissecans. Fragments that can be displaced by intraoperative probing or tangentially aligned impaction forces the surface... In young people whose growth plates haven ’ t closed yet or completely separated in... Can progress to the overlying articular cartilage with subchondral bone Radiology 2008 ; [... Or completely separated loose, causing pain and possibly hindering joint motion a basketball game, resulting in of... Plates haven ’ t closed yet shoulder and hip to a subchondral fatigue fracture usually a. In determining lesion stability and the cartilage inside a joint undergoes softening joint which catches and during.: Magnetic resonance imaging revealed a lateral trochlear OCD extending into the anterior lateral femoral condyle with that!