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Review
. 2023 Feb;17(1):47-53.
doi: 10.1177/18632521221149054. Epub 2023 Jan 28.

Osteochondritis dissecans of the knee: Imaging, instability concept, and criteria

Franck Accadbled  1 , Marco Turati  2   3   4 , Mininder S Kocher  5
Affiliations
Review

Osteochondritis dissecans of the knee: Imaging, instability concept, and criteria

Franck Accadbled et al. J Child Orthop. 2023 Feb.

Abstract

Osteochondritis dissecans of the knee is an idiopathic, focal, subchondral-bone abnormality that can cause instability or detachment of a bone fragment and overlying articular cartilage, with subsequent progression to osteoarthritis. The degree of lesion instability is best assessed by magnetic resonance imaging. Unstable lesions require operative management with fragment fixation. Level of evidence: V.

Keywords: MRI; Osteochondritis dissecans; adolescent; instability; knee; sports.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
MRI, coronal view, gradient echo sequence with fat signal suppression: thin line of low signal between the epiphyseal cartilage and the surface cartilage.
Figure 2.
Figure 2.
MRI, coronal view, T1-weighted sequence: low-signal fragment within the subchondral bone.
Figure 3.
Figure 3.
MRI, sagittal view, proton density sequence with fat signal suppression: heterogeneous low signal from the fragment within the subchondral bone on the T2 image.
Figure 4.
Figure 4.
MRI, coronal view, proton density sequence with fat signal suppression: fragment protruding beyond the epiphyseal contour with the disappearance of the overlying surface cartilage.
Figure 5.
Figure 5.
Oreo cookie sign: curvilinear hyperintense T2 signal at the interface of the progeny and the parent, sandwiched between two layers of hypointense–hypointense signal.
Figure 6.
Figure 6.
Irregular ossification of the lateral condyle. Differential diagnosis of OCD.
Figure 7.
Figure 7.
MRI, coronal view, T2-weighted sequence with fat signal suppression: double line with an internal high-signal line of fluid intensity rimmed by a low-signal line, indicating instability.
Figure 8.
Figure 8.
MRI, sagittal view, T2-weighted sequence with fat signal suppression: two cysts around the fragment.
Figure 9.
Figure 9.
Kocher MRI classification.
Figure 10.
Figure 10.
Case example. Arthroscopic view after OAT and transarticular drilling.
See this image and copyright information in PMC

References

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