Juvenile Osteochondritis Dissecans: Correlation of Findings on Histopathology and MRI Andrew Zbojniewicz MD*, Keith Stringer MD**, Tal Laor MD*, Eric Wall MD*** Departments of Radiology*, Pathology**, and Orthopedics*** Cincinnati Children’s Hospital Medical Center University of Cincinnati College of Medicine Juvenile Osteochondritis Dissecans: Is It a Growth Disturbance of the Secondary Physis of the Epiphysis? When patients with JIA have persistent pain or mechanical symptoms despite treatment of their inflammation, other causes must be considered. Methods: MRI analysis of 122 knees and 132 JOCD lesions in 109 patients who underwent arthroscopic treatment for osteochondritis dissecans lesions of the knee between March 2003 and January 2011. Purpose: To retrospectively compare the sensitivity and specificity of previously described magnetic resonance (MR) imaging criteria for the detection of instability in patients with juvenile or adult osteochondritis dissecans (OCD) of the knee, with arthroscopic findings as the reference standard. Objective: To discuss the case of a patient with osteochondritis dissecans, a common disorder primarily affecting children and adolescent patients that involves the medial femoral condyle, and to examine its radiologic appearance.Clinical Features: A 25-year-old man with knee pain sought treatment at a chiropractic clinic. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Read "Juvenile osteochondritis dissecans: a 5-year review of the natural history using clinical and MRI evaluation, Pediatric Radiology" on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Author information: (1)Rocky Mountain Youth Sports Medicine Institute, Rocky Mountain Hospital for Children, CO, USA. 36. Osteochondritis dissecans (OCD) includes a spectrum of joint disease involving articular cartilage, 1,6,12,26 with the subchondral bone lesion having the potential to progress to varying degrees of osseous resorption, collapse, detachment, and violation of the overlying articular cartilage, which may result in intra-articular loose body formation. Juvenile Osteochondritis Dissecans: Cartilage T2 Mapping of Stable Medial Femoral Condyle Lesions Radiology . The name juvenile osteochondrosis is more specific, since it excludes those definitely post-traumatic malarias, such as Kümmel's, Preiser's, and Kienböck's disease, which do occur in adult life. Kijowski R, Blankenbaker DG, Shinki K, Fine JP, Graf BK, De Smet AA. Typically seen in children and young people, JOCD is primarily an active youth person’s condition. OCD is seen in children and adolescents with open growth plates (juvenile OCD) and adults with closed growth plates (adult OCD). Quantitatively measured T2 values did not significantly differ between cartilage overlying juvenile osteochondritis dissecans lesions and normal cartilage on the medial femoral condyle. Radiography and magnetic resonance imaging (MRI) are the primary modalities used to … is primarily a dis … With JOCD, there is a loosening of a piece of bone and the cartilage that covers it. Address 2018 Aug;288(2):536-543. doi: 10.1148/radiol.2018171995. Nonoperative treatment of stable juvenile osteochondritis dissecans (JOCD) lesions of the knee fails in up to 50% of cases. This case highlights a relatively asymptomatic patient with a large osteochondral defect. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondritis Dissecans Osteochondritis dissecans. (2008) Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. To the Editor: Joint pain and swelling are common symptoms of patients with juvenile idiopathic arthritis (JIA) with active joint inflammation. Osteochondritis dissecans of the talus is a particular form of osteochondral lesions of the talus. Nowadays, the term of Osteochondritis Dissecans (OCD) is the most widely used for an idiopathic fracture line extending through the articular cartilage and the underlying bone in the knee [1, 2]. Nguyen JC, Liu F, Blankenbaker DG, Woo KM, Kijowski R. Juvenile osteochondritis dissecans: cartilage T2 mapping of stable medial femoral condyle lesions. A cell-free biomimetic osteochondral scaffold showed positive results in adult patients. Polousky JD(1). 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. This article is a review of the current understanding of the etiology, pathogenesis, and how to diagnose and treat knee osteochondritis dissecans (OCD) followed by an analysis of and outcomes of the treatments available. Osteochondritis dissecans (OCD) can lead to disabling arthritis if not recognized and treated appropriately in the early stages. Osteochondritis dissecans is traditionally divided into juvenile (open physes) and adult (closed physes) based on skeletal maturity. A joint is where two bones come together. Author: Vijay Shankar, M.D. Osteochondritis dissecans (o.d.) Kijowski R et al. Clinical Relevance: This paradigm shift in understanding of juvenile osteochondritis dissecans etiology and disease progression may critically impact future patient management. Anterior Knee Pain; Chondral Defect of the Knee; Effects of a Partial Meniscectomy on Articular Cartilage; Knee Arthritis; Osteochondritis Dissecans of the Knee The optimal treatment for a stable juvenile osteochondritis dissecans lesion remains controversial because the condition is rare, the relative success of various treatments is unknown, the condition progresses or healsslowly, and there are Juvenile osteochondritis dissecans (JOCD) has been a recognized entity for more than 100 years. Juvenile Osteochondritis Dissecans: Correlation Between Histopathology and MRI Andrew M. Zbojniewicz1 Keith F. Stringer2 Tal Laor1 Eric J. Wall3 Zbojniewicz AM, Stringer KF, Laor T, Wall EJ 1Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229. Tal Laor 1, Andrew M. Zbojniewicz 1, Emily A. Eismann 2 and Eric J. Despite our long recognition of OCD, the natural history and most effective therapies are poorly understood. ... Radiology description. The DESS sequence is helpful to confirm cartillage integrity and allows the orthopedic surgical team to make plans for micro-drilling of the lesion. Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Within the risk factors, repetitive trauma is accepted [1, 3]. The patient had a 2-year history of left knee pain that was … Although conclusive evidence of an exact cause is lacking, there is widespread agreement that JOCD is related to repetitive trauma. johnpolousky@msn.com Juvenile osteochondritis dissecans (JOCD) has been a recognized entity for more than 100 years. Background: Recent data suggest magnetic resonance imaging (MRI) is the best method to analyze the status of the cartilage and subchondral bone in patients with juvenile osteochondritis dissecans (JOCD). Topic Completed: 1 February 2013. Normal hard bone is covered with a softer form of bone called cartilage at the joint surface. Healing predictors are needed to identify potential failures and thus determine treatment options. Radiology 248: 571–578 248: 571–578 Well demarcated defect in articular surface of joint Case reports. Repetitive trauma to the articular surfaces with the softer cartilage is thought to be the primary cause of OCD [1] , [2] . 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. The specimens from 50 operated cases of osteochondritis dissecans of the distal femur were analyzed histopathologically. Osteochondritis dissecans (OCD) can affect both adults and children, however the imaging characteristics and significance of imaging findings can differ in the juvenile subset with open physes. all unstable juvenile osteochondritis dissecans lesions at the time of presentation6. MRI is commonly used to assess the stability of OCD lesions of the knee . Radiology, 248(2):571-578, 13 Jun 2008 Cited by: 59 articles | PMID: 18552309 A trauma with subsequent osteochondral defect detected immediately by radiology has to be differentiated from osteochondritis dissecans of the talus. We define unstable OCD lesions as those with fragments that can be displaced by intraoperative probing. Radiology 2018; … Share Claim CME + Affiliations: 1 Department of Radiology, Cincinnati Children?? Wall 2. ?s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229. Juvenile osteochondritis dissecans. OCD usually causes pain during and after sports. Osteochondrosis is a disease of the growth centers, and has its … The exact cause of OCD is still unknown. Juvenile Osteochondritis Dissecans is a condition of the joint surfaces and underlying bone that occurs in people who are still growing. Juvenile osteochondritis disse-cans (OCD) is a frequent cause of knee pain in children. Background:Several magnetic resonance imaging (MRI) classification systems have been developed to determine the degree of instability of juvenile osteochondritis dissecans (JOCD) lesions. Of knee pain in Children JIA have persistent pain or mechanical symptoms treatment! ( 1 ) Rocky Mountain Youth Sports Medicine Institute, Rocky Mountain Sports. 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