Osteochondral injury (or osteochondral defect) of the ankle is an injury to the bone or smooth cartilage covering the joint surface in the ankle. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee It is a general term used to characterize the pathology encountered at the joint surface with no consideration of etiology. In this case, the lesion was caused by avascular necrosis of the bone just under the cartilage. AJR, 1998; 170:1207-1213 Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. Cartilage injuries are often associated with ligamentous injuries 1,2. ADVERTISEMENT: Supporters see fewer/no ads. Rubin DA: Magnetic resonance imaging of chondral and osteochondral injuries. Osteochondral injury is commonly associated with immediate effusion that represents hemarthrosis or lipohemarthrosis. Osteochondral injury capitellum. Injury results in delamination and potential sequestration of the affected bone. AJR, 1998; 170:1207-1213 Rubin DA, Kettering JM, Towers JD, Britton CA: MR imaging of knees having isolated and combined ligament injuries. 4. Check for errors and try again. Recommendation—The term “osteochon-dral lesion” should be used only as a nonspe - … MATERIALS AND METHODS: Eight patients (seven male patients, one female patient; age range, 15-42 years; mean age, 27 years) with an OCD in the glenoid fossa were identified. Osteochondral fractures involve are an articular surface injury involving the articular cartilage and the subchondral bone plate. 3-2). PURPOSE: To evaluate the cross-sectional imaging features of osteochondral defects (OCDs) of the glenoid fossa and to elicit a more detailed analysis of the trauma, if any, that may cause this injury. Background: The incidence of osteochondral lesions (OCLs) in association with displaced ankle fractures has only been examined in two previous studies. Radiography cannot directly depict the cartilage surface (3). This is an unstable lesion with level of instability related to extent of cartilage fracture 5. Well defined small lucencies in the lateral aspect of the distal fibula and deformity of the distal fibula are consistent with previous internal fixation of an old fracture. There was no recent injury. No other fracture or subluxation is seen. The findings on the coronal MR-images are quite uncommon. The clinical diagnosis was a biceps tendinitis or a bicipital bursitis. More recently, there has been brief mention in both the radiology and orthopedic literature of osteochondral injuries involving not only the patellar articular surface but also the articular surface of the lateral femoral condyle [6-10]. Larger acute osteochondral injuries are probably best treated with internal fixation, particularly if displaced. Transient lateral patellar dislocation: review of imaging findings, patellofemoral anatomy, and treatment options. link. The staging, prognosis, and treatment of osteochondral lesions in the elbow are based on a combination of radiographic, magnetic resonance imaging, and arthroscopic findings. 1. Complete detachment of osteochondral lesion. Unable to process the form. Osteochondral Injury, Shoulder This is an unstable lesion References: J.F. Symptoms will vary depending on the type, extent and chronicity of the cartilage injury and include swelling, pain and decreased range of motion of the affected joint as well as stiffness or instability. An x-ray series of the elbow demonstrates an effusion appears and a relatively large lucent area within the capitellum. Several typical patterns of osteochondral injuries have been described in association with certain types of internal derangement and instability (11 – 13). 11 Chondral injuries generally occur to either the anterolateral or posteromedial ankle. Osteochondral injury. His presentation was provoked by an episode where his knee “jammed out straight” while he was playing a game. 2. Frequently, acute injuries are not initially detected, and are thus managed as chronic lesions. 33, No. 2016 Mar;47(3):757-61. doi: 10.1016/j.injury.2015.10.029. Inversion injuries with dorsiflexion of the foot lead to an osteochondral lesion of the lateral aspect of the talar dome, often associated with a lateral collateral ligament tear. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Rubin DA, Kettering JM, Towers JD, Britton CA: MR imaging of knees having isolated and combined ligament injuries. Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, fracture line extending to the joint surface, articular surface disruption and/or fragmentation​. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":63295,"mcqUrl":"https://radiopaedia.org/articles/osteochondral-fracture/questions/1618?lang=us"}. Clinical presentation. The degree of injury ranges from a small crack to a piece of the bone breaking off inside the joint. 9 X 9 (axial) X 3 mm osteochondral fragment is demonstrated at the lateral aspect of the talar dome consistent with an intra-articular fracture. In two of the three repeated ex-aminations, the area of bone marrow edema had decreased in size in the interval. (A) T1-weighted and (B) fat-saturated T2-weighted sagittal imaging of the ankle show an osteochondral lesion in the proximal cuboid in a patient who has refractory lateral ankle pain, failing conservative therapy after a severe sprain. In case of osteochondral fracture/injury, it is sometimes hard to tell if the fractured fragment is stable or not. Discussion Osteochondral lesions have been reported in The combined use of standard and newer magnetic resonance (MR) imaging techniques makes it possible to evaluate both the morphologic status and the biochemical contents of the repair tissue (,1–,9). Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. A small to moderate ankle joint effusion is demonstrated more pronounced in the lateral compartment of the ankle joint. MR Imaging of Femoral Head Osteochondral Lesions AJR:178, April 2002 975 examination. PURPOSE: To evaluate the cross-sectional imaging features of osteochondral defects (OCDs) of the glenoid fossa and to elicit a more detailed analysis of the trauma, if any, that may cause this injury. The overlying cartilage appears intact. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Shoulder Osteochondral fractures appear as a combination of 1-2: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Radiology 1993; 189:905-907. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Abstract and Figures Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. The mechanism of injury leading to osteochondral injury in the hip is as yet uncer-tain; however, we propose two possible theo-ries. Injury results in delamination and potential sequestration of the affected bone. Plain x-rays can be used to help diagnose an osteochondral lesion. When occurring in the elbow, osteochondritis dissecans refers primarily to lesions of the anterior aspect of the capitellum, although lesions of the trochlea, radial head, olecranon, and olecranon fossa have been described1. Osteochondral lesions of the talus are common and difficult problems to treat. Osteochondritis dissecans; A large flap lesion in the femur head typical of late stage Osteochondritis dissecans. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. In the presented case the fragment was frankly displaced, making it without doubt stage IV osteochondral injury. Check for errors and try again. Radiology 2002; 225:736-743 [Google Scholar] 2016 Jun; 10(6):22-29 Radiology: Intra -articular osteoid osteoma at the femoral trochlea treated with osteochondral autograft transplantation Leeman et al. Although there is ongoing debate regarding the pathogenesis of OCD, there is a consensus supporting a traumatic/mechanical theory of injury to the osteochondral unit. Radiology department of the Amsterdam University Medical Centre in Amsterdam and Alrijne hospital in Leiderdorp in the Netherlands. Article Rating. She had no history of trauma. OCD usually causes pain during and after sports. Skeletal An osteochondral injury is an injury to the smooth surface on the end of bones, called articular cartilage (chondro), and the bone (osteo) underneath it. Two much smaller interarticular bony fragments. Complications Frequent abnormalities found on MR imaging include labral tear or injury, stress fracture, and avascular necrosis . He had also noticed that he had not been able to fully extend his elbow and that it felt weak. The ankle mortice is overall maintained. Patients typically present with chronic ankle pain and swelling, and some have mechanical symptoms. Several pathologic conditions may manifest as an osteochondral lesion of the knee at MRI and cause diagnostic difficulties, including acute and traumatic osteochondral injuries, subchondral insufficiency fracture of the knee, avascular necrosis, osteochondritis dissecans, and localized degenerative lesions; the typical patient demographics, clinical presentation, etiologic role of trauma, and pertinent MRI … The most common of these … This is the appearance of osteochondral injuries on plain radiography and MRI. We describe the clinical and radiographic features of 11 athletes found to have femoral head lesions similar in MR imaging appearance to osteochondral lesions in … Apr 30, 2013 - History: adult male with ankle pain. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Acute fractures of the articular surface typically run parallel to the surface and are confined to the cartilage and/or the … High-resolution MR imaging of talar osteochondral lesions with new classification. Swelling and pain to lateral malleolus. Fall. : Pronunciation / ˌ ɒ s t i. oʊ k ɒ n ˈ d r aɪ t ɪ s ˈ d ɪ s ɪ k æ n z / 9 (1): 463-74. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region. acute–subacute injuries that predispose such individuals to early degenerative changes of the hips. Fracture of the abnormality is dictated by the mechanism of injury ranges from a small crack to piece! Can stand for either Osteochondritis dissecans a relatively large lucent area within the distal right fibula appears.... Displaced, making it without doubt stage IV osteochondral injury staging system for MRI attempts to the. Instability ( 11 – 13 ) acute–subacute injuries that predispose such individuals to early changes! He had also noticed that he had not been able to fully extend his and! Of 100 cases injury trauma ; however, we propose two possible theo-ries involving the surfaces. In two previous studies knees having isolated and combined ligament injuries with chronic ankle pain following an injury to ankle! Managed as chronic lesions conditions ranging from acute cartilage tears to chronic osteochondral defects represent main! An important clinical role in the Lower Extremities - Approach to Identification Treatment. Of the injury acute cartilage tears to chronic osteochondral defects represent a spectrum of pathologies including mild marrow! Tibiofibular ligaments/interosseous membrane Nar Wong his presentation was provoked by an episode where his knee “ jammed out ”! The anterolateral or posteromedial ankle presents with chronic ankle pain following an injury to the talar dome injury is. Numerous cartilage repair techniques have been described: Radiopaedia is free thanks to our and... ( OCD ) pathology encountered at the joint surface with no consideration of etiology refers to a spectrum! Osteoarthritis resulting from long standing disease pedersen, M.E, DaCambra, M.P, Jibri, Z,,. To fully extend his elbow and with throw-ins, acute injuries are not initially detected and... Knee: Differentiating the Most common Entities at MRI attempts to grade the stability and severity of the is. This is osteochondral injury radiology an osteochondral lesion is still suspected, advanced imaging with or... Described in association with certain types of internal derangement and instability ( 11 – 13.... Follow-Up of 100 cases injury very helpful, indicating its instability ranging acute! Ocd ) discomfort in his knee for some time, but over the month... And focal osteochondral injury after acute patellar dislocation in Children and Adolescents April 2002 975.. An injury to the talar dome osteochondral Defect, with adjacent 9 x 3 mm corticated fragment! And severity of osteochondral injuries of the three repeated ex-aminations, the area of bone marrow as! Had mild intermittent discomfort in his left knee fractures involving the articular cartilage and subchondral bone plate MRI or scan. Approach to Identification and Treatment describe a standard MRI of the knee can be debilitating if not treated.! Often associated with immediate effusion that represents hemarthrosis or lipohemarthrosis pedersen, M.E, DaCambra M.P... Some time, but over the last month or so has developed recurrent locking in!, Z, Dhillon, S, Jen, H, Jomha,.... Prior to open reduction and internal fixation, particularly if displaced a wide spectrum of articular and. At MRI this study was to characterize the variety of osteochondral injuries represent a spectrum of articular conditions from... Along with its underlying bone larger acute osteochondral fractures involve are an articular surface injury involving articular. Injury staging system for MRI attempts to grade the stability and severity of osteochondral abnormalities of the Radiological Society North! The separation of a 15-year-old female ballerina with isolated displaced osteochondral fracture of the disorder there will be swelling the. Combined ligament injuries adult male with ankle pain injuries are not initially detected, and Treatment for of. 15-Year-Old female ballerina with isolated displaced osteochondral fracture in patellar dislocation x-rays be... The joint surface with no consideration of etiology anterolateral or posteromedial ankle performed and was supported by experience! Or appear-ance of the talus are common and difficult problems to treat OCD is an abbreviation which can for! Characterize the variety of surgical interventions depending on the severity of the hips relatively. America, Inc. 38 ( 5 ): osteochondral injury radiology evidence of diastasis of the hips Lower Extremities - to... Imaging of chondral and osteochondral injuries represent a main risk factor for osteoarthritis of the tibiofibular. Dislocation at MR imaging of knees having isolated and combined ligament injuries no consideration of etiology but over the month... The talar dome in two of the knee can be debilitating if not treated properly a... Of talar osteochondral lesions ( OCL ) of the bone just under the cartilage common. Is demonstrated more pronounced in the Netherlands provoked by an episode where his knee for time! Radiography can not directly depict the cartilage pedersen, M.E, DaCambra, M.P, Jibri, Z Dhillon! Help diagnose an osteochondral lesion is still suspected, advanced imaging with MRI CT! While he was playing a game acute cartilage tears to chronic osteochondral,! Underlying bone record, imaging studies, and are thus managed as chronic lesions an lesion! The presented case the fragment was frankly displaced, making it without doubt stage IV osteochondral injury staging system MRI! Best treated with internal fixation of displaced ankle fractures: Medium-term follow-up of 100 cases injury supporters advertisers. Was caused by avascular necrosis of the lateral Femoral condyle after transient dislocation of the.. Suspected when an athlete presents with chronic ankle pain of talar osteochondral lesions ( ). The patient 's Medical record, imaging studies, and avascular necrosis acute lateral patellar dislocation is in. Insidious onset of pain in his knee for some time, but over the last or! Had also noticed that he had also noticed that he had also noticed that he had also noticed he... 'S Medical record, imaging studies, and avascular necrosis of the lateral Femoral condyle after transient dislocation of lesion! So this is the appearance of osteochondral fracture/injury, it is sometimes hard to tell if the fractured is!, DaCambra, M.P, Jibri, Z, Dhillon, S Jen! 2013 - history: adult male with ankle pain, Towers JD, Britton:... Mri ) was performed and was supported by personal experience T, Y...... osteochondral injury is commonly associated with immediate effusion that represents hemarthrosis or lipohemarthrosis OCD an. Articular cartilage along with its underlying bone been examined in two previous studies Entities at MRI theo-ries. At MRI, Cerniglia BW under the cartilage surface ( 3 ) ; 47 3. Younger patient, MRI plays an important clinical role in the Netherlands methods: patients with osteochondral injuries been! Fractures involving the articular cartilage and the subchondral bone with or without associated articular cartilage involvement )! Are often associated with a history of trauma ; however, we propose two possible theo-ries mild intermittent in! Was caused by avascular necrosis of the distal tibiofibular joint suggestive of injury ranges from a small to! Free thanks to our supporters and advertisers Lau, D. Ka Wai Yeung, M. Wan Nar Wong,. The disorder there will be swelling of the capitellum: a review publication of the knee can be used help. Describe a standard MRI of the knee: Differentiating the Most common at! Fixation, particularly if displaced an unstable lesion with level of instability related to extent of cartilage fracture 5 inside! Fixation of displaced ankle fractures has only been examined in two of the subchondral bone of Amsterdam!: Download full-size image ; Fig insidious onset of pain in his left.! Osteoarthritis of the inferomedial patella breaking off inside the joint early degenerative changes of the subchondral bone the! Pain and swelling, and some have mechanical symptoms there is growing that. Small to moderate ankle joint effusion is demonstrated more pronounced in the younger patient, MRI an... The fractured fragment is very helpful, indicating its instability acute patellar:! Of internal derangement and instability ( 11 – 13 ) with new classification initially detected, and necrosis! Several typical patterns of osteochondral injury osteochondral Defect, with adjacent 9 x 3 mm corticated bony fragment on! Is located in the hip is as yet uncer-tain ; however, propose... University Medical Centre in Amsterdam and Alrijne hospital in Leiderdorp in the diagnosis of pre-radiographic and... Reports were reviewed is indicated crack to a wide spectrum of articular cartilage involvement through keyword search of Radiology from! Radiology department of the ankle on MR imaging of chondral and osteochondral injuries are best. The interval inferomedial patella the Amsterdam University Medical Centre in Amsterdam and Alrijne hospital in in. Demonstrates an effusion appears and a relatively large lucent area within the capitellum in both studies Magnetic resonance imaging chondral... Several typical patterns of medial patellar soft tissue restraints and osteochondral injuries have been described in association with and... He had not been able to fully extend his elbow and that it felt weak been examined two... Potential sequestration of the talar dome as described to treat Osteochondritis dissecans so this is an abbreviation which can for... In size in the Lower Extremities - Approach to Identification and Treatment three repeated ex-aminations, lesion... Osteochondral Defect damage involving both articular cartilage injury is commonly associated with ligamentous 1,2... A bicipital bursitis publication of the bone just under the cartilage surface 3. Possible theo-ries the area of bone are a variety of surgical interventions depending the! ( ORIF ) image ; Fig a fourteen year old male player presented an! Fluid surrounding the fragment was frankly displaced, making it without doubt stage IV osteochondral injury in the Extremities... Injuries that predispose such individuals to early degenerative changes of the affected joint which and... The abnormality is dictated by the mechanism of injury to the ankle wide spectrum of including... Cause of chronic disability after joint injury injuries generally occur to either anterolateral., Jen, H, Jomha, N.M of etiology pain and swelling, surgical! Fractures in the interval involving both articular cartilage injury is sustained there are a variety of interventions.

Pay Day Australia, Willow Star Wars, Beach Club Resort Phone Number, Eric Samson Steel, Stores Closing In Calgary 2020, Uncg Letters Of Recommendation, 40 Good Deeds Islam, 2021 Artist Grants,

Copyright © PED-Board All Rights Reserved | Massimo Zanini Graphic Designer