Comparison of sonography and MRI in the evaluation of stability of capitellar osteochondritis dissecans

Abstract

PurposeTo compare the diagnostic accuracies of ultrasonography (US) and magnetic resonance imaging (MRI) with intraoperative capitellar osteochondritis dissecans (COCD) fragment stability findings.MethodsPatients whose International Cartilage Repair Society (ICRS) osteochondritis dissecans (OCD) classifications were I/II (stable) or III (unstable) were included. Patients underwent preoperative US and MRI. On US, lesions were evaluated as unstable when irregular contours of the chondral surface were observed. On MRI, lesions were evaluated as unstable when articular bone irregularity, a T2 high signal intensity interface, or a high signal intensity line through the articular cartilage was observed. Using the surgical assessment as the gold standard, accuracies of fragment stability diagnoses were calculated for US and MRI.ResultsThirty‐four patients with OCD classifications of I/II (stable) or III (unstable) were included. Twenty‐four patients (stable: 12, unstable: 12) underwent preoperative US; 22 (stable: 11, unstable: 11) underwent preoperative MRI. Preoperative US and MRI stability assessments correctly matched intraoperative fragment findings in 23 of 24 patients and 16 of 22 patients, respectively. US criteria in this study achieved superior accuracy compared with MRI criteria (96% vs. 73%; P < .05).ConclusionUS was a useful tool for evaluating fragment instability in COCD.

Preoperative Evaluation and Surgical Simulation for Osteochondritis Dissecans of the Elbow Using Three-Dimensional MRI-CT Image Fusion Images

“…The corresponding rate between each finding determined from the MCFI and those determined intraoperatively were evaluated. We calculated the corresponding rate as follows: (number of cases in which the findings determined by the MCFI corresponded to the actual intraoperative findings)/(total number of cases) [ 17 ].…”

“…The subchondral bone and articular cartilage of the humeral capitellum are affected, and several possible causes, including repetitive microtrauma and genetic factors, are implicated [ 3 , 4 , 6 , 7 ]. Although the stability and size of the lesion are considered important factors impacting lesion severity [ 6 , 8 , 9 , 10 ], no single imaging modality can adequately predict lesion severity [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ], thereby presenting a challenge to elbow surgeons. A recent study by Pu et al concluded that a combination of radiography, computed tomography (CT), and magnetic resonance imaging (MRI) can most accurately determine OCD lesion stability by compensating for the respective flaws of the individual modalities [ 18 ].…”

Osteochondritis Dissecans of Smaller Joints: The Elbow

“…Surprisingly, ultrasound achieved superior results than MRI. 42 Further studies on the use of ultrasound diagnostic are needed to confirm these findings in a larger group of patients.…”

Osteochondrosis dissecans des Ellenbogengelenks

“…Wie bereits beschrieben tritt Als Diagnostikum zur Evaluation der Fragmentstabilität hat die Sonographie an Aufmerksamkeit ebenfalls gewonnen. Die Unterscheidung zwischen instabilen und stabilen Fragmenten zeigt sich hierbei durch eine chondrale Konturunterbrechung, wie bereits in mehreren Studien belegt werden konnte [31,57].…”