IS Case 340: Osteochondritis dissecans

Amira Farouga, MD

Imaging Sciences URMC


2009 URMC Imaging Sciences
Publication Date: 2009-11-09

History

Patient is an 11-year-old male with left knee pain.

Findings

Osteochondral fracture in the medial femoral condyle on the left side. A radiolucent line is seen separating the osteochondral body from the femoral condyle.

Discussion

Osteochondritis dissecans is a relatively common condition, seen predominantly in adolescents and young adults and more often in males than in females. It has recently come to be considered a form of osteochondral fracture caused by chronic injury. The most common location is the lateral aspect of the medial femoral condyle.

In the early stages of the disease, conventional radiographs in the standard projections usually show no abnormality. In more advanced stages of the disease, a radiolucent line is seen separating the osteochondral body from the femoral condyle. Double-contrast arthrography can differentiate an in situ lesion from a more advanced lesion, where the osteochondral body is partially or completely detached from its bed. Sometimes combining arthrography with CT or performing MRI may need to be used.

References

  1. Murray JR, Chitnavis J, Dixon P, et al. Osteochondritis dissecans of the knee; long-term clinical outcome following arthroscopic debridement. Knee. 2007 Mar;14(2):94-8. PMID: 17222556

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