0 0 vote. 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. The articular cartilage imaging group of the International Cartilage Repair Society has issued detailed recommendations with r… Osteochondral injury capitellum. 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. The incidence is similar, but lateral talar dome injuries … Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. This is the appearance of osteochondral injuries on plain radiography and MRI. In this article a systematic approach is presented on how to describe a standard MRI of the ankle. Osteochondral fracture of the lateral femoral condyle is a rare injury of the knee joint, which mostly occurs in adolescence 1.In adolescence, the cartilage‐bone interface is the weakest transitional area in the knee joint, and there is no obvious boundary between calcified and uncalcified cartilage 2.The biomechanical strength of immature osteochondral junction was lower … 2016 Mar;47(3):757-61. doi: 10.1016/j.injury.2015.10.029. Two much smaller interarticular bony fragments. Osteochondral lesions of the talus are common and difficult problems to treat. Osteochondral lesions of the elbow are injuries that disrupt the cartilage and subjacent bone, and they most commonly involve the capitellum. The mechanism of injury leading to osteochondral injury in the hip is as yet uncer-tain; however, we propose two possible theo-ries. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee Complications acute–subacute injuries that predispose such individuals to early degenerative changes of the hips. An x-ray series of the elbow demonstrates an effusion appears and a relatively large lucent area within the capitellum. the radiology and orthopedic literature of os-teochondral injuries involving not only the patellar articular surface but also the articular surface of the latera l femoral condyle [6–10]. No CT evidence of diastasis of the distal tibiofibular joint suggestive of injury to the tibiofibular ligaments/interosseous membrane. A small to moderate ankle joint effusion is demonstrated more pronounced in the … 5 3 votes. Background: The incidence of osteochondral lesions (OCLs) in association with displaced ankle fractures has only been examined in two previous studies. Numerous cartilage repair techniques have been described for managing OLTs. 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). Apr 30, 2013 - History: adult male with ankle pain. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft tissue restraints and osteochondral injuries of the inferomedial patella. Osteochondral injury is commonly associated with immediate effusion that represents hemarthrosis or lipohemarthrosis. Radiology department of the Amsterdam University Medical Centre in Amsterdam and Alrijne hospital in Leiderdorp in the Netherlands. The degree of injury ranges from a small crack to a piece of the bone breaking off inside the joint. Unable to process the form. Materials and methods: Patients with trochlear abnormalities were identified through keyword search of radiology dictations from 1999 to 2007. Soft tissue swelling adjacent to the lateral malleolus. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Shoulder. With regard to concomitant tendon injuries of the ankle, MRI evidence of an injury to the tibialis posterior tendon was more common in the group with both an OLT and an osteochondral lesion of the distal tibia and fibula than in the group with only an OLT according to both readers (p = 0.001 for reader A and p = 0.012 for reader B). First mover in Radiology & Web 2.0. Acute Osteochondral Fractures in the Lower Extremities - Approach to Identification and Treatment. This is essential in determining management. Shoulder and Humerus. Intra-articular osteochondral fracture of the talar dome as described. Rubin DA: Magnetic resonance imaging of chondral and osteochondral injuries. 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. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. 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. Radiology department of the Amsterdam University Medical Centre in Amsterdam and Alrijne hospital in Leiderdorp in the Netherlands. Osteochondral fractures involve are an articular surface injury involving the articular cartilage and the subchondral bone plate. Top Magn Reson Imaging 1998; 9:348-359. Top Magn Reson Imaging 1998; 9:348-359. The patient's medical record, imaging studies, and surgical reports were reviewed. 20, No. An inversion injury to the ankle with the foot in plantar flexion and lateral rotation of the tibia on the talus lead to a posteromedial talar dome lesion ( , 47 , , 48 ). The findings on the coronal MR-images are quite uncommon. Osteochondritis dissecans of the capitellum primarily affects male athletes between 12 an… Normal alignment. Cartilage injuries are often associated with ligamentous injuries 1,2. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee The clinical diagnosis was a biceps tendinitis or a bicipital bursitis. Trauma. Larger acute osteochondral injuries are probably best treated with internal fixation, particularly if displaced. AJR, 1998; 170:1207-1213 Osseous Pathology. Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. {"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"}. Patients typically present with chronic ankle pain and swelling, and some have mechanical symptoms. 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​. Osteochondral Lesion “Osteochondral lesion” is a broad and nonspecific term that has been used to refer to any lesion that involves the articular sur-face and subchondral region of a joint, af-fecting cartilage, bone, or both. He described pain with any weight bearing activities through his elbow and with throw-ins. ADVERTISEMENT: Supporters see fewer/no ads. : 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 / Articular cartilage injuries of the knee can be debilitating if not treated properly. Swelling and pain to lateral malleolus. 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 … Yi Lau, D. Ka Wai Yeung, M. Wan Nar Wong. An osteochondral injury involves the separation of a segment of articular cartilage along with its underlying bone. She had no history of trauma. (2015) The Open Orthopaedics Journal. Particularly in the younger patient, MRI plays an important clinical role in the diagnosis of pre-radiographic OA and focal osteochondral injury. AJR, 1998; 170:1207-1213 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. No acute fracture identified. Frequent abnormalities found on MR imaging include labral tear or injury, stress fracture, and avascular necrosis . Osteochondral Injury – Coronal T2 weight MRI with fat saturation confirms a large osteochondral injury at the lateral talar dome (yellow arrow) with marked surrounding bone edema characterized by high T2 signal. Publicationdate 2019-03-01. Osteochondritis dissecans; A large flap lesion in the femur head typical of late stage Osteochondritis dissecans. Pedersen, M.E, DaCambra , M.P, Jibri, Z, Dhillon, S, Jen , H, Jomha, N.M. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Prominent anterior talar neck spur noted. This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. (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. Radiology 2002; 225:736-743 [Google Scholar] Recommendation—The term “osteochon-dral lesion” should be used only as a nonspe - … The ankle mortice is overall maintained. 4. If you would see this in the capitellum you would call it an osteochondral lesion of the capitellum. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. Article Rating. Diagnosis. Case This 17 year old elite footballer presents with recurrent locking symptoms in his left knee. The staging, prognosis, and treatment of osteochondral lesions in the elbow are based on a combination of radiographic, magnetic resonance imaging, and arthroscopic findings. 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. When planning the treatment of osteochondral lesions of the talus, it is important to evaluate the articular cartilage to distinguish between stable and unstable lesions (1, 2). In this study, we aimed to precisely localize the hyperintense signal that is generated at the osteochondral junction when using ultrashort echo time magnetic resonance imaging (MRI) and to investigate the osteochondral junction using sweep imaging with Fourier transformation (SWIFT) MRI. 33, No. Two much smaller interarticular bony fragments. 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. Subsequent MR imaging shows that there is a 15 mm osteochondral lesion at the lateral capitellum with separation of a bony fragment that is approximately 13 x 11 x 6 mm in depth. Lateral talar dome osteochondral defect, with adjacent 9 x 3 mm corticated bony fragment. 5. Injury results in delamination and potential sequestration of the affected bone. 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. In case of osteochondral fracture/injury, it is sometimes hard to tell if the fractured fragment is stable or not. In the presented case the fragment was frankly displaced, making it without doubt stage IV osteochondral injury. MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment (see: osteochondral injury staging and osteochondritis dissecans surgical staging). 3-2). Objectives: The aim of this article is to provide an overview of current optimal clinical cartilage imaging techniques of the foot and ankle and to show typical osteochondral injuries on imaging. 1 . Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. Radiology Case. So this is called an osteochondral … Materials and methods: A thorough literature search was performed and was supported by personal experience. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Check for errors and try again. Radiology 1993; 189:905-907. Unable to process the form. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. OCD usually causes pain during and after sports. 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]. Several typical patterns of osteochondral injuries have been described in association with certain types of internal derangement and instability (11 – 13). 1). He had also noticed that he had not been able to fully extend his elbow and that it felt weak. Download : Download high-res image (107KB) Download : Download full-size image; Fig. rts * ABSTRACT CASE Radiographs of the right knee did not show any abnormality (Fig 1). In this case, the lesion was caused by avascular necrosis of the bone just under the cartilage. Rubin DA, Kettering JM, Towers JD, Britton CA: MR imaging of knees having isolated and combined ligament injuries. Once an articular cartilage injury is sustained there are a variety of surgical interventions depending on the severity of the injury. This article presents a case of a 15-year-old female ballerina with isolated displaced osteochondral fracture of the patella without patellar dislocation. 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