Radiographic evaluation of osteochondritis dissecans of the humeral capitellum: A systematic review

Pu, Alex; Jauregui, Julio J.; Salmons, Harold I.; Weir, Tristan B.; Abzug, Joshua M.; Gilotra, Mohit N.

doi:10.1016/j.jor.2021.09.005

Cited by 5 publications

(2 citation statements)

References 45 publications

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“…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 ]. However, at present, surgery is the only means of conclusively confirming the severity of OCD lesions using the classification proposed by the International Cartilage Repair Society (ICRS) [ 19 , 20 , 21 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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We used our novel three-dimensional magnetic resonance imaging-computed tomography fusion images (3D MRI-CT fusion images; MCFIs) for detailed preoperative lesion evaluation and surgical simulation in osteochondritis dissecans (OCD) of the elbow. Herein, we introduce our procedure and report the findings of the assessment of its utility. We enrolled 16 men (mean age: 14.0 years) and performed preoperative MRI using 7 kg axial traction with a 3-Tesla imager and CT. Three-dimensional-MRI models of the humerus and articular cartilage and a 3D-CT model of the humerus were constructed. We created MCFIs using both models. We validated the findings obtained from the MCFIs and intraoperative findings using the following items: articular cartilage fissures and defects, articular surface deformities, vertical and horizontal lesion diameters, the International Cartilage Repair Society (ICRS) classification, and surgical procedures. The MCFIs accurately reproduced the lesions and correctly matched the ICRS classification in 93.5% of cases. Surgery was performed as simulated in all cases. Preoperatively measured lesion diameters exhibited no significant differences compared to the intraoperative measurements. MCFIs were useful in the evaluation of OCD lesions and detailed preoperative surgical simulation through accurate reproduction of 3D structural details of the lesions.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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“… 12 , 21 , 30 Several MRI classification systems for capitellar OCDs have been proposed, focusing predominately on fluid or signal intensity at the interface or surface of the lesion with cartilage changes. 7 , 13 However, the sensitivity and specificity of these systems with International Cartilage and Regeneration and Joint Preservation Society grades are less than ideal, 28 and these classifications have not been assessed against the ability to portend outcomes. Further, these classification systems fail to consider additional factors that have been shown to influence recovery, particularly radial head enlargement along with the location 14 and size of the lesion.…”

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confidence: 99%

MRI Features That Contribute to Decision-Making for Treatment of Capitellar OCD Lesions: An Expert Consensus Using the Delphi Method

Kostyun,

Nguyen,

Chhabra

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Most healthcare providers utilize magnetic resonance imaging (MRI) to assist in diagnosing and treating osteochondritis dissecans (OCD) of the capitellum. However, consensus on imaging features that portend clinically relevant information in the care of these lesions has not been determined. Purpose: To conduct a survey on the MRI features of a capitellar OCD that are salient for clinical decision-making using a classic Delphi protocol. Study Design: A consensus statement. Methods: Invitations to participate were sent to 33 healthcare providers identified as capitellar OCD experts. A classic 3-round survey method was used to gather agreement and consensus on the level of importance for clinical decision-making on 33 MRI features. A concise list of features that guide decision-making on the stability of an OCD lesion and the ability of an OCD lesion to heal with nonoperative care was also identified. Agreement and consensus were determined a priori as ≥66%. Results: Of the 33 identified experts, 20 agreed to participate, and 17 (52%) completed all 3 rounds. Of the 33 MRI features evaluated, 17 reached agreement as important for clinical decision-making by the experts. Consensus was reached for a concise list of MRI features that were significant to decision-making (94%), suggestive of a stable lesion (100%), had the potential to heal with nonoperative treatment (94%), were suggestive of an unstable lesion (100%), and had low potential to heal with nonoperative treatment (88%). Conclusion: This 3-round Delphi process produced consensus on clinically relevant MRI features that contribute to clinical decision-making for capitellar OCD. The results of this study will be used as the basis for an interrater reliability assessment of the identified salient features, creating the foundation for developing a reliable MRI assessment tool rooted in clinical experiences. The development of a standardized assessment of capitellar OCD is intended to improve clinical practice and patient outcomes.

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Knorpel-Knochen-Transfer bei Osteochondrosis dissecans des Capitulum humeri

Klug,

Sauter,

Hoffmann

2024

Oper Orthop Traumatol

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Radiographic evaluation of osteochondritis dissecans of the humeral capitellum: A systematic review

Cited by 5 publications

References 45 publications

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

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

MRI Features That Contribute to Decision-Making for Treatment of Capitellar OCD Lesions: An Expert Consensus Using the Delphi Method

Knorpel-Knochen-Transfer bei Osteochondrosis dissecans des Capitulum humeri

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