Along with the popularity of youth movement, the incidence of osteochondritis dissecans (OCD) showed a trend of increase, but its pathogenesis is not yet clear. Previous studies suggested that trauma is the main potential cause, but with the emergence of vast family cases, hereditary factor is also gradually taken seriously. Arthroscopy is the "gold standard" for diagnosing OCD, but for the patient with early incomplete joint surface lesions, the diagnositic value of MRI is better than the arthroscopy. For the patients with stable form OCD, nonoperative management should be used such as adjusting activity, fixator and drugs; for the patient with unstable form OCD or failing after conservative treatment, surgery should be generally used such as joint clearing, drilling, microfracture method, fixation and transplantation. With the progress of research, stem cell technology and platelet-rich plasma gradually applied in cartilage repair, which will improve the curative effect of OCD, but still further clinical and experimental research, and also a long-term effective follow-up are needed.
Humans ; Osteochondritis Dissecans ; diagnosis ; etiology ; therapy

To evaluate the radiographic characteristics of osteochondritis dissecans (OCD) and useful parameter for predicting mechanical stability, we retrospectively analysed 26 plain radiographic examinations and seven MR imagings in 28 cases of OCD in 24 patients. Typical radiologic findings were osteochondral defect with sclerotic rim of variable thickeness and osteochondral fragment. Sites of osteochondral defect were medial (35.9%) or lateral (32%) femoral chondyle and medial (7.1%) or lateral (25%) side of talar dome. Sclerotic rim was seen in 24 cases (85%) and osteochondral fragments including nine loose bodies were seen in 21 cases (75%). The size of osteochondral defect with unstable fragment (average 2.05cm) and loose body (2.04cm) in the knee joint were similar to, but statistically larger than that with stable fragment (1.35cm). All osteochondral defects were well visualized on MR images. Abnormalities of articular cartilage and effusion in the interface between the parent bone and fragment were seem in five cases of which there were confirmed three unstable cases arthroscopically. We conclude that size of defect may be a good parameter for predicting mechanical stability and MRI may be useful in the diagnosis of OCD and determining the methods of treatment.
Cartilage, Articular ; Diagnosis ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Osteochondritis Dissecans* ; Osteochondritis* ; Parents ; Retrospective Studies

A case of osteochondritis dissecans of talus developed in a 10-year-old girl is reported Since the first description by Konig in 1888 of this entity, many has been reported but that of ankle joint has been of lesser occasion. Clinical diagnosis in this case could be made with the painful swelling and tenderness on the lateral aspect of the left ankle for four months with roentgenological demonstration of marked sclerosis of the separted fragment of the left talus. Surgical removal of the detached fragment was successful with uneventful functional recovery of the joint.
Ankle ; Ankle Joint ; Child ; Diagnosis ; Female ; Humans ; Joints ; Osteochondritis Dissecans ; Osteochondritis ; Sclerosis ; Talus

A case of osteochondritis dissecans of both knee joints is developed in 15 year old boy. Since the original articles of Paget, Koning and others were reported, many theories as to etiology and pathogenesis have been proposed but exact cause has been unknown. Many Joint may show evidence of osteochondritis dissecans but lateral aspect of medial femoral condyle of knee is by far the most frequent site. Under the diagnosis of osteochondritis dissecans of both knees with clinical symptoms and X-ray finding, the one was treated with excision of framents and curettage, and the other treated with drilling of fragments. In follow up study for one year, the result was good without any complaints.
Curettage ; Diagnosis ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteochondritis Dissecans ; Osteochondritis

Osteochondritis dissecans of the femoral head following Legg-Calve-Perthes disease has been considered a rare complication. Catterall, in 1982, reviewed the literature and found only 54 reported cases proving the relative rarity of this condition. Of the 363 hips with Legg-Calve-Perthes disease treated at the Chonnam University Hospital for 15 years from 1973 to 1987, osteochondritis dissecans of the femoral head developed in seven(1.9%). The seven patients with osteochondritis dissecans were male and over seven years old at the time of diagnosis of Legg-Calve-Perthes disease. Since six patients had nearly silent hip, treatment was not advised. In remaining one patient, the lesion was drilled and grafted with bone chips. Spontaneous healing of osteochondritis dissecans was observed in three patients.
Diagnosis ; Head ; Hip ; Humans ; Jeollanam-do ; Legg-Calve-Perthes Disease ; Male ; Osteochondritis Dissecans ; Osteochondritis ; Transplants

PURPOSE: To evaluate the role of CT in early detection, location, and extent of osteochondritis dissecans (OCD) of the elbow joint. MATERIALS AND METHODS: We reviewed surgically proved 27 cases of 22 patients with osteochondritis dissecans in elbow joint retrospectively. We compared simple x-ray(elbow AP & lateral) with CT on the basis of staging of OCD of talus by simple x-ray. RESULTS: The frequency of location was as follows:fourteen cases of capitellum, 5 cases of olecranon tip, 5 cases of medial epicondyle, 2 cases of trochlea, and 1 case of olecranon base. Among the 4 cases of normal finding on simple x-ray, CT showed 1 case each of stage I, II, III, and IV OCD and among the 8 cases of stage I on simple x-ray, CT showed 2 cases of stage I, 1 case of stage II, and 5 cases of stage III. Among the 3 cases of stage II on simple x-ray, CT showed 1 case of stage II and 2 cases of stage III. Among the 5 cases of stage III on simple x-ray, CT showed 1 case of stage II, 2 cases of stage III, and 2 cases of stage IV, but it was difficult to detect the presence or absence of attachment between the articular cartilage of mother bone and osteochondral fragment. CT was more accurate than simple x-ray in detection of loose body. CONCLUSION: CT might be an useful imaging modality in early diagnosis of OCD and evaluation of its anatomic location and extent in elbow joint.
Cartilage, Articular ; Early Diagnosis ; Elbow Joint* ; Elbow* ; Humans ; Mothers ; Olecranon Process ; Osteochondritis Dissecans* ; Osteochondritis* ; Retrospective Studies ; Talus

Syphilis was known to be generalized disease and it had been decreased until 1960's. But, it has been increased again recently. The author analysed the 22 cases of congenital syphilis which were treated at department of orthopaedic surgery at Ewha Womans University Hospital from Jan. 1979 to July 1983 and the following results were obtained. 1. There were no significant changes of the number of patient by years. 2. Common symptom and sign were hepatosplenomegaly(84%), fever(62%) and skin changes(50%), and pseudoparalysis was observed in one case. 3. Radiologic bone changes were observed in 11 cases (50%) and the following results were obtained: a. Below the two week old, there was relatively low incidence of bone change with 22%. b. There was high incidence of bone change in prematurity with 75%. c. Common features of bone changes were periosteal reaction, osteochondritis and metaphysitis (91%). Pathologic fracture was observed. in one case. 4. Although we have observed the bone changes only in 50% of cases, all the other reports has reported more than 80% and we thought that radiologic bone change would aid the diagnosis of congenital syphilis.
Clinical Study ; Diagnosis ; Female ; Fractures, Spontaneous ; Humans ; Incidence ; Osteochondritis ; Skin ; Syphilis ; Syphilis, Congenital

In children, snapping knee syndrome and joint pain with the loss of physiological hyperextension strongly suggests a diagnosis of a torn discoid meniscus. We performed arthroscopic meniscectomy to treat torn discoid lateral meniscus on 19 knees and open meniscectomy on 9 knees of 26 children(average age: 10.9 yrs) from September, 1983 to October, 1993 at Guro hospital. According to Ikeuchi's grading system', excellent results were obtained in 14, good in 11, fair in 2 knees and poor in 1 knee which was associated with osteochondritis dissecans. The knees treated by partial meniscectomy showed less Fairbank's radiologic changes than those by total meniscectomy during the average follow-up 4.2 years(minimum 1 year, maximum 7 year 11 months).
Arthralgia ; Child ; Diagnosis ; Follow-Up Studies ; Humans ; Knee ; Menisci, Tibial ; Osteochondritis Dissecans

Osteochondral lesions of the femoral head are uncommon and few studies have reported their imaging findings. Since joints are at risk of early degeneration after osteochondral damage, timely recognition is important. Osteochondral lesions of femoral head may often be necessary to differentiate from avascular necrosis. Here, we report a case of osteochondral lesions on bilateral femoral heads. This lesion manifested as subchondral cysts in initial radiographs, which led to further evaluation by computed tomography arthrography and magnetic resonance imaging, which revealed overlying cartilage defects.
Female ; Hip Joint/abnormalities/*radiography ; Humans ; Magnetic Resonance Imaging ; Osteochondritis/*diagnosis ; Patients ; Sports ; Tomography, X-Ray Computed ; Young Adult