Osteochondral Lesions in Pediatric and Adolescent Patients

Abstract

Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. Injury results in delamination and potential sequestration of the affected bone. Although an association with mechanical and traumatic factors has been established, the etiology remains poorly understood. These lesions commonly occur in the knee; articular surfaces of the elbow, ankle, hip, and shoulder are also affected. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. Many of these lesions are first diagnosed by plain film. MRI adds value by identifying unstable lesions that require surgical intervention. This review focuses on the clinical and imaging features of osteochondral lesions of the knee, elbow, and ankle. Imaging criteria for staging and management are also reviewed.

Elbow MR arthrography with traction

“…For example, osteochondritis dissecans of the capitellum is one of the leading causes of long-term elbow disability in young athletes. [36][37][38] Trochlear and trochlear notch chondromalacia occurs in throwing athletes with medial instability, 39 while osteochondral injury of the capitellum is a feature of posterolateral rotatory instability. 40 Capitellar cartilage injury also occurs in about 10% of patients with radial head fracture.…”

Using Magnetic Resonance Imaging to Identify Complications Associated with Bioabsorbable Implant Fixation of Osteochondral Lesions: A Practical Guide

“…This primary bone pathology may result in secondary injury to overlying cartilage. Conversely, an osteochondral fracture occurs when an acute trauma disrupts the subchondral bone as well as the overlying articular cartilage [12].…”

“…“Osteochondral lesion” is an umbrella term used for an array of disorders related to the subchondral bone and overlying cartilage, including osteochondritis dissecans (OCD) and osteochondral fractures [8, 12, 26]. These injuries constitute an increasing health burden on the growing numbers of recreational and professional athletes of all ages [14].…”

AutoCart – minimalno invazivna metoda liječenja osteohondralnih lezija u djece i adolescenata

“…Mehanizmi ozljede su sile zbijanja, smicanja ili avulzija fragmenta. 1,2 Osteohondritis disekans (OCD) je žarišno oštećenje zglobne hrskavice i pripadajuće subhondralne kosti nejasne etiologije. Nastanak OCD-a danas se najčešće tumači kombinacijom ponavljajućih mikrotrauma, biomehaničke neusklađenosti i oskudne vaskularizacije zahvaćene kosti.…”

“…Od simptoma kojima se prezentira subhondralna lezija dominantni su bol, ograničenost funkcije te povremeni edem oko zahvaćenog zgloba. 2 Dijagnostika osteohondralnih lezija trebala bi uključivati običan rendgenski pregled koji podrazumijeva anteriorno-posteriorni, bočni i kosi prikaz zgloba. Za naprednu dijagnozu koriste se CT i MR. Svaka metoda ima svoje prednosti i nedostatke.…”