Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, Vermont See all articles by this author. When it becomes necrotic, the overlying cartilage is devitalized, and frequently the entire fragment separates out and forms an intra-articular loose body. Usually a small area of bone adjacent to the articulating surface is affected. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. Osteochondritis Dissecans of the Talus (Transchondral Fractures of the Talus): Review of the Literature and New Surgical Approach for Medial Dome Lesions Show all authors. Osteochondritis dissecans occurs in approximately 15 to 29 per 100,000 patients. 2012 Sep 26. . The etiology is unknown, although trauma has been implicated, particularly in lateral lesions. Magnetic resonance imaging (MRI) ... Flick AB, Gould N. Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. 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. Introduction. Osteochondritis dissecans has been reported to affect the ankle as the third most common joint, ... Sagittal magnetic resonance image (MRI) of the talus showing an osteochondral lesion on the posterior aspect of the talar dome. Helping you find trustworthy answers on Osteochondritis Dissecans of Talus | Latest evidence made easy Since 1983, 24 children have been treated for OCD of the talus at a major Canadian pediatric referral center. The lesion is encountered on either the medial or lateral surface of the talar dome. Characteristic MRI findings of osteochondral lesions of the talus have been reported. MRI classification of juvenile osteochondritis dissecans lesions Hefti F ... Aggarwal V, et al. Proximal surface of talus ; Head of 1 st metatarsal ; Most patients are athletic ... Osteochondritis dissecans. Diagnosis of OCD, based on MRI findings, is quite straightforward; MRI examination can also be very useful for dating the defect and obtaining information about the associated bone bruise. Osteochondritis dissecans was originally described in 1888 as a process of loose body formation associated with articular cartilage and subchondral bone fracture in the hip and knee. 1 The first description of these lesions in the ankle was provided in 1922. This guide will help you understand. Osteochondritis dissecans, if not recognized and treated appropriately, may lead to secondary osteoarthritis with pain … 20. We examined how they change before and after treatment and discussed their significance. Physical examination typically reveals an effusion, tenderness, and a crackling sound with joint movement. Osteochondritis dissecans is an aseptic necrosis of subchondral bone and the overlying cartilage. Osteochondritis dissecans is an aseptic necrosis of subchondral bone and the overlying cartilage. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. Osteochondritis dissecans of the talus. In children whose bones are still growing, the bone defect may … The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. Magnetic Resonance Imaging After Arthroscopic Microfracture of Capitellar Osteochondritis Dissecans. Case contributed by Dr Matt Skalski Diagnosis certain Diagnosis certain . It can occur in all age groups. In 13 of 14 patients who had had correlative surgery, we accurately … Osteochondritis Dissecans (OCD) Injuries & Conditions Osteochondritis Dissecans is a condition that affects synovial joints , resulting in localised abnormalities of the articular cartilage, such that the cartilage softens and can eventually dislodge and become a floating loose body within the knee. Osteochondritis dissecans (OCD) of the talus is rare in children. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. Radiology. Patient Data. Loading images... Sagittal T1 . Usually a small area of bone adjacent to the articulating surface is affected. Twenty two ankles in 21 patients had MRI examination before and after treatment of the talar lesion. When it becomes necrotic, the overlying cartilage is devitalized, and frequently the entire fragment separates out and forms an intra-articular loose body. 2008 Aug. 248(2):571-8 Transchondral fracture of the talus Berndt AL, Harty M. Transchondral fracture (osteochondritis dissicans) of the talus. Osteochondritis dissecans (OCD) of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. We studied the value of MR imaging in determining the stability of the osteochondral fragments. Osteochondritis dissecans of the talus. Ankle pain. Osteochondritis dessicans of the talus in a 26-year-old woman. Osteochondritis dissecans of medial femoral condyle-ovoid fragment of bone is separated from surface of condyle but does not yet lie freely within the joint. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. J Bone Joint Surg Am. Red arrows point to osteochondral defect and bone edema on T1 and stir MRI images of the knee in same patient as above. 17 April 2014 | European Radiology, Vol. MRI. Osteochondritis dissecans (OCD) of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. Osteochondral lesions of the talus can be associated with injury to the ankle. Even the smallest osteochondritis dissecans lesion will appear on a MRI of the ankle and talus region. ... MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study. B. Flick . Osteochondritis dissecans has been reported to affect the ankle as the third most common joint, after the knee and the elbow.1 A 26-year-old housewife presented with chronic ankle pain for 3 weeks duration with intermittent swelling after exertion, without any history of trauma. Foot Ankle 1985; 5:165. This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March 1, 2011, and May 31, … This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long … The impending separation of the osteochondral fragment is in keeping of grade III lesion. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. In 1888 Konig was the first author to use the term osteochondritis dissecans to describe loose bodies found in the knee joint; he believed them to be fragments from an avascular bone lesion . Is MRI superior to helical CT? The authors have no funding and conflicts of interest to disclose. The detached osteochondral fragment AS a source of cells for autologous chondrocyte implantation (ACI) in the ankle joint. Males are typically affected twice as often as females, with a higher incidence occurring in young athletes. [1] OCD usually causes pain and swelling of the affected joint which catches and locks during movement. A Patient’s Guide to Osteochondritis Dissecans of the Talus Introduction. Osteochondritis dessicans of the talus in a 26-year-old woman. Osteochondritis dissecans (OCD) is an acquired idiopathic lesion of subchondral bone that can produce delamination and sequestration with or without articular cartilage involvement and instability. Osteoarthritis Cartilage 2005;13: 601–607. Based on the clinical picture and results of the blood investigations such as … This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. 2 article feature images from this case. 2 case question available. B. Flick, M.D. Zanon G(1), DI Vico G(2), Marullo M(1). Ankle sprains are a common cause of OLTs. 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. BMJ Case Reports 2009; doi:10 .1136/bcr.06.2008.0091 [Citation ends]. Giannini S, Buda R, Grigolo B, et al. In 1888 Konig was the first author to use the term osteochondritis dissecans to describe loose bodies found in the knee joint; he believed them to be fragments from an avascular bone lesion . 8. A. Osteochondritis dissecans (OCD) is a lesion of subchondral bone with subsequent involvement of the overlying cartilage. Coronal MRI image of the talus showing an osteochondral lesion on the medial aspect of the talar dome. 7. The majority of OLTs, as many as 85 percent, occur after a traumatic injury to the ankle joint. Care of the Young Athlete, 2nd ed, Anderson SJ, Harris SS, Gregory AJM (Eds), American Academy of Pediatrics, Elk Grove Village 2010. No single treatment works for everybody. Presentation. Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. With this type of injury, a section of the talus surface may impact another part of the ankle joint (tibia or fibula). Clinical management of these lesions is based on whether or not the fragments are attached. * A. Although it can occur from childhood through adult life, the majority of patients are 10 to 20 years of age. 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. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Abbreviations: MRI = magnetic resonance imaging, OCD = osteochondritis dissecans, trochlear groove OCD = OCD involving the trochlear groove. The value of magnetic resonance imaging in the clinical course of steochondrosis dissecans in the knee and ankle joints [in German]. Occasionally other studies may be helpful such as a computed tomography (CT scan) to further define the anatomy of the lesion and occasionally a bone scan is … J Bone Joint Surg 2005;87B:41–46. 7. Figure 4. Case Discussion. 1959;41:988 … Causes of Osteochondritis dissecans . Features are consistent with osteochondritis dissecans of the ankle joint. Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. 24, No. Am J Sports Med. MRI is the single best study for both the diagnosis and prognosis of the osteochondritis dissecans lesion of the talus. Osteochondritis dissecans occurs most often in children and adolescents. Find all the evidence you need on Osteochondritis Dissecans of Talus via the Trip Database. Orthop J Sports Med … strategies in osteochondral lesions of the talus. Age: 35 Gender: Male From the case: Osteochondritis dissecans of the talus. [Figure caption and citation for the preceding image starts]: Coronal magnetic resonance image (MRI) of the talus showing an osteochondral lesion on the medial aspect of the talar dome Gupta RK, Kansay R, Aggarwal V, et al. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. 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