Semin Musculoskelet Radiol 2018; 22(01): 057-065
DOI: 10.1055/s-0037-1608006
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pediatric Osteochondral Lesions

Selwan B. Abdullah
1   Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Maryland
,
Ramesh S. Iyer
2   Department of Radiology, Seattle Children's Hospital, Seattle, Washington
,
Narendra S. Shet
3   Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
06. Februar 2018 (online)

Abstract

Osteochondral lesions are common in children and may arise from a variety of etiologies. Although they most frequently occur in the knee, other joints may be involved including the ankle and elbow. We describe the typical imaging appearance of osteochondral lesions with a focus on radiographs and magnetic resonance imaging. Assessment of the stability of these lesions is of paramount importance in directing management. As such, we describe staging schemes as well as imaging features differentiating stable from unstable lesions. Finally, we briefly discuss management strategies as they correlate to imaging findings.

 
  • References

  • 1 Kessler JI, Nikizad H, Shea KG, Jacobs Jr JC, Bebchuk JD, Weiss JM. The demographics and epidemiology of osteochondritis dissecans of the knee in children and adolescents. Am J Sports Med 2014; 42 (02) 320-326
  • 2 McElroy MJ, Riley PM, Tepolt FA, Nasreddine AY, Kocher MS. Catcher's knee: posterior femoral condyle juvenile osteochondritis dissecans in children and adolescents. J Pediatr Orthop 2016
  • 3 Ghahremani S, Griggs R, Hall T, Motamedi K, Boechat MI. Osteochondral lesions in pediatric and adolescent patients. Semin Musculoskelet Radiol 2014; 18 (05) 505-512
  • 4 Kocher MS, Tucker R, Ganley TJ, Flynn JM. Management of osteochondritis dissecans of the knee: current concepts review. Am J Sports Med 2006; 34 (07) 1181-1191
  • 5 Edmonds EW, Polousky J. A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from König to the ROCK study group. Clin Orthop Relat Res 2013; 471 (04) 1118-1126
  • 6 Chiroff RT, Cooke III CP. Osteochondritis dissecans: a histologic and microradiographic analysis of surgically excised lesions. J Trauma 1975; 15 (08) 689-696
  • 7 Perumal V, Wall E, Babekir N. Juvenile osteochondritis dissecans of the talus. J Pediatr Orthop 2007; 27 (07) 821-825
  • 8 Wall E, Von Stein D. Juvenile osteochondritis dissecans. Orthop Clin North Am 2003; 34 (03) 341-353
  • 9 De Smet AA, Ilahi OA, Graf BK. Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. Skeletal Radiol 1997; 26 (08) 463-467
  • 10 Bohndorf K. Osteochondritis (osteochondrosis) dissecans: a review and new MRI classification. Eur Radiol 1998; 8 (01) 103-112
  • 11 Kramer J, Stiglbauer R, Engel A, Prayer L, Imhof H. MR contrast arthrography (MRA) in osteochondrosis dissecans. J Comput Assist Tomogr 1992; 16 (02) 254-260
  • 12 Saupe N, Zanetti M, Pfirrmann CWA, Wels T, Schwenke C, Hodler J. Pain and other side effects after MR arthrography: prospective evaluation in 1085 patients. Radiology 2009; 250 (03) 830-838
  • 13 Giaconi JC, Link TM, Vail TP. , et al. Morbidity of direct MR arthrography. AJR Am J Roentgenol 2011; 196 (04) 868-874
  • 14 Samora WP, Chevillet J, Adler B, Young GS, Klingele KE. Juvenile osteochondritis dissecans of the knee: predictors of lesion stability. J Pediatr Orthop 2012; 32 (01) 1-4
  • 15 Wu Y-Y, Orth RC, Guillerman RP, Zhang W, Kan JH. Marginal value of radiographs in the interpretation of MR images obtained for pediatric knee pain. AJR Am J Roentgenol 2013; 200 (04) 891-894
  • 16 Cahill BR, Berg BC. 99m-Technetium phosphate compound joint scintigraphy in the management of juvenile osteochondritis dissecans of the femoral condyles. Am J Sports Med 1983; 11 (05) 329-335
  • 17 Berndt AL, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am 1959; 41-A (06) 988-1020
  • 18 Nelson DW, DiPaola J, Colville M, Schmidgall J. Osteochondritis dissecans of the talus and knee: prospective comparison of MR and arthroscopic classifications. J Comput Assist Tomogr 1990; 14 (05) 804-808
  • 19 Hefti F, Beguiristain J, Krauspe R. , et al. Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society. J Pediatr Orthop B 1999; 8 (04) 231-245
  • 20 Chen C-H, Liu Y-S, Chou P-H, Hsieh C-C, Wang C-K. MR grading system of osteochondritis dissecans lesions: comparison with arthroscopy. Eur J Radiol 2013; 82 (03) 518-525
  • 21 Jacobs Jr JC, Archibald-Seiffer N, Grimm NL, Carey JL, Shea KG. A review of arthroscopic classification systems for osteochondritis dissecans of the knee. Orthop Clin North Am 2015; 46 (01) 133-139
  • 22 Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 2003; 85-A (Suppl. 02) 58-69
  • 23 Ellermann JM, Donald B, Rohr S. , et al. Magnetic resonance imaging of osteochondritis dissecans: validation study for the ICRS classification system. Acad Radiol 2016; 23 (06) 724-729
  • 24 Aglietti P, Buzzi R, Bassi PB, Fioriti M. Arthroscopic drilling in juvenile osteochondritis dissecans of the medial femoral condyle. Arthroscopy 1994; 10 (03) 286-291
  • 25 Milgram JW. Radiological and pathological manifestations of osteochondritis dissecans of the distal femur. A study of 50 cases. Radiology 1978; 126 (02) 305-311
  • 26 Gebarski K, Hernandez RJ. Stage-I osteochondritis dissecans versus normal variants of ossification in the knee in children. Pediatr Radiol 2005; 35 (09) 880-886
  • 27 De Smet AA, Fisher DR, Burnstein MI, Graf BK, Lange RH. Value of MR imaging in staging osteochondral lesions of the talus (osteochondritis dissecans): results in 14 patients. AJR Am J Roentgenol 1990; 154 (03) 555-558
  • 28 Kumai T, Takakura Y, Higashiyama I, Tamai S. Arthroscopic drilling for the treatment of osteochondral lesions of the talus. J Bone Joint Surg Am 1999; 81 (09) 1229-1235
  • 29 O'Farrell TA, Costello BG. Osteochondritis dissecans of the talus. The late results of surgical treatment. J Bone Joint Surg Br 1982; 64 (04) 494-497
  • 30 Chang GH, Paz DA, Dwek JR, Chung CB. Lower extremity overuse injuries in pediatric athletes: clinical presentation, imaging findings, and treatment. Clin Imaging 2013; 37 (05) 836-846
  • 31 Canale ST, Belding RH. Osteochondral lesions of the talus. J Bone Joint Surg Am 1980; 62 (01) 97-102
  • 32 Letts M, Davidson D, Ahmer A. Osteochondritis dissecans of the talus in children. J Pediatr Orthop 2003; 23 (05) 617-625
  • 33 Higuera J, Laguna R, Peral M, Aranda E, Soleto J. Osteochondritis dissecans of the talus during childhood and adolescence. J Pediatr Orthop 1998; 18 (03) 328-332
  • 34 Bruns J, Rosenbach B. Osteochondrosis dissecans of the talus. Comparison of results of surgical treatment in adolescents and adults. Arch Orthop Trauma Surg 1992; 112 (01) 23-27
  • 35 Zellner B, May MM. Elbow injuries in the young athlete—an orthopedic perspective. Pediatr Radiol 2013; 43 (Suppl. 01) S129-S134
  • 36 Marshall KW, Marshall DL, Busch MT, Williams JP. Osteochondral lesions of the humeral trochlea in the young athlete. Skeletal Radiol 2009; 38 (05) 479-491
  • 37 Bowen RE, Otsuka NY, Yoon ST, Lang P. Osteochondral lesions of the capitellum in pediatric patients: role of magnetic resonance imaging. J Pediatr Orthop 2001; 21 (03) 298-301
  • 38 Delgado J, Jaramillo D, Chauvin NA. Imaging the injured pediatric athlete: upper extremity. Radiographics 2016; 36 (06) 1672-1687
  • 39 Pruthi S, Parnell SE, Thapa MM. Pseudointercondylar notch sign: manifestation of osteochondritis dissecans of the trochlea. Pediatr Radiol 2009; 39 (02) 180-183
  • 40 Cahill BR. Osteochondritis dissecans of the knee: treatment of juvenile and adult forms. J Am Acad Orthop Surg 1995; 3 (04) 237-247
  • 41 Hughston JC, Hergenroeder PT, Courtenay BG. Osteochondritis dissecans of the femoral condyles. J Bone Joint Surg Am 1984; 66 (09) 1340-1348
  • 42 Smillie IS. Treatment of osteochondritis dissecans. J Bone Joint Surg Br 1957; 39-B (02) 248-260
  • 43 Ewing JW, Voto SJ. Arthroscopic surgical management of osteochondritis dissecans of the knee. Arthroscopy 1988; 4 (01) 37-40
  • 44 Guhl JF. Arthroscopic treatment of osteochondritis dissecans. Clin Orthop Relat Res 1982; (167) 65-74