Correlation of Magnetic Resonance Imaging to Arthroscopic Findings of Stability in Juvenile Osteochondritis Dissecans

Heywood, C; Benke, Michael T.; Brindle, Kathleen A.; Fine, Kenneth M.

doi:10.1016/j.arthro.2010.07.009

Cited by 59 publications

(38 citation statements)

References 22 publications

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“…In the pediatric age group, if only one criterion for instability is applied, most lesions will be overcalled, with a specifi city of only 15 % (although the sensitivity will be 100 %). If two criteria are applied, diagnosis will be much more specifi c (about 90 %), but instability will be missed half the time [ 36 ]. Overcalling high-signal fl uid between the fragment and parent bone may contribute to low specifi city.…”

Section: Imagingmentioning

confidence: 97%

The Foot and Ankle: Acquired Disorders

Kan

2014

Pediatric Orthopedic Imaging

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Injuries to the pediatric ankle and foot are common and increasing due to the popularity of organized youth sports. Fracture and dislocation patterns vary based on skeletal maturity, position of the ankle and foot at the time of injury, and direction of force. Ankle fractures unique to children, such as triplane and juvenile Tillaux, are addressed initially. Fractures of the foot are then presented based on their position within the hindfoot, midfoot, and forefoot. Discussions of osteochondritis dissecans of the talar dome and the various osteochondroses of the mid-and forefoot follow, and the chapter concludes with a brief review of ankle impingement syndromes.Injuries to the pediatric ankle and foot are common and increasing due to the popularity of organized youth sports. Fracture and dislocation patterns vary based on skeletal maturity, position of the ankle and foot at the time of injury, and direction of force. Ankle fractures have unique patterns in children, such as triplane and juvenile Tillaux fractures. Fractures of the foot are addressed based on their position within the hindfoot (talus and calcaneus), midfoot (cuneiforms, cuboid, navicular), and forefoot (metatarsals and phalanges). Osteochondritis dissecans of the talar dome and the various osteochondroses of the mid-and forefoot may cause chronic pain

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Section: Imagingmentioning

confidence: 97%

The Foot and Ankle: Acquired Disorders

Kan

2014

Pediatric Orthopedic Imaging

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“…Defining which lesions are unstable is more difficult in youths than adults. Heywood et al 21 found that 21 of 23 juvenile OCD lesions were judged to be unstable on MRI; however, only 10 were unstable at arthroscopy. They used widely accepted MRI criteria to assess stability.…”

Section: Juvenile Osteochondritis Dissecansmentioning

confidence: 97%

Knee injuries in the youth athlete

Bowen¹

2012

Current Orthopaedic Practice

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As community-based, organized youth sports have increased in popularity over the last several years, so has the rise of pediatric orthopaedic sports medicine as a subsubspecialty. Although nonsurgical fractures and overuse injuries are seen most commonly, the incidence of surgical injuries, particularly about the knee, is on the rise. This article will review and synthesize recent advances in the treatment of knee disorders resulting from youth sports participation.

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“…Likely because of the relatively low reported prevalence of osteochondritis dissecans 25 , the current evidence in the literature is based on small sample sizes, often with locations of lesions such as elbow, ankle, and knee combined, for determining the diagnostic performance of MRI relative to arthroscopy in identifying osteochondritis dissecans lesions 24,26,27 . The limitation of most diagnostic studies that examine the validity of screening tools such as MRI and that use arthroscopy as a gold standard comparison is that not all patients identified as having a potential osteochondritis dissecans lesion have an arthroscopic evaluation.…”

Section: Methodological Quality Of the Studiesmentioning

confidence: 99%

“…The sensitivity and specificity of the use of combined imaging criteria for characterizing the stability of osteochondritis dissecans lesions were different, depending on the type of osteochondritis dissecans lesion (juvenile or adult), with 100% sensitivity and 100% specificity reported for the detection of adult lesions and 100% sensitivity and only 11% specificity for the juvenile form. A study by Heywood et al, which assessed juvenile osteochondritis dissecans lesions in both the knee and talus, yielded a sensitivity of 100% but a specificity of only 15% for diagnosing fragment stability; the concordance between arthroscopic stage and MRI stage was 30% 24 . The study by Heywood et al was not included in the results of the current investigation because the talus and knee sensitivity and specificity were grouped for the study analyses, and information pertaining only to the knee was not provided.…”

mentioning

confidence: 99%