Osteochondritis dissecans (knee)

Case contributed by Amr Farouk
Diagnosis certain

Presentation

A male patient with history of knee pain for 2 months.

Patient Data

Age: 20-25 years
Gender: Male
  • Lateral femoral condyle anterior surface & inferolateral portion osteochondral ulcers .
  • Two loose bodies are seen at the anterior tibiofemoral joint space ,with the largest measuring about 7 X 13 mm along its maximal craniocuadal & transverse diameters.
  • Mild osteoarhteritic changes are seen with minimal marginal osteophytic lippings of the opposing tibial & femoral surfaces,sharp tibial spines & lateral femoral condyle pseuodocystic changes.
  • Lateral femoral condyle anterior surface & inferolateral portion osteochondral ulcers are seen elciting low signal on T1 & T2 WI with high signal on STIR WIs.
  • Two loose bodies are seen at the anterior tibiofemoral joint space ,with the largest measuring about 7 X 13 mm along its maximal craniocuadal & transverse diameters.They elicit low signal on T1 & T 2 WI.
  • Mild osteoarhteritic changes are seen with minimal marginal osteophytic lippings of the opposing tibial & femoral surfaces,sharp tibial spines & lateral femoral condyle pseuodocystic changes.
  • Normal MRI appearance of menisci, ACL, PCL, collateral and patellar retinacular ligaments as well as the quadriceps and infra patellar tendons. 
  • Intact peri-articular musculature with preserved intervening fat planes. 
  • Mild amount of intra-articular synovial effusion is noted, associated with localized synovial fluid collection in gastrocnemius/semimembranosus bursa. 

Case Discussion

Osteochondritis of medial femoral condyle with displaced osteochondral fragment, subchondral pseudocyst formation & mild osteoarthritis (osteochondritis dissecans).

 

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