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