Osteochondritis dissecans - knee MRI

Case contributed by Bahman Rasuli
Diagnosis certain


Follow-up MRI of a known knee problem.

Patient Data

Age: 30 years
Gender: Male

Osteochondral defect on the lateral aspect of the medial femoral condyle

A 5*16 mm floating osteochondral fragment within the femorotibial joint lies anteriorly in the intercondylar notch

Irregularity of the medial femoral condyle middle weight-bearing surface associated with subchondral sclerosis and cystic changes

The remainder of the knee is normal.

Case Discussion

Osteochondral defect is a focal area of articular damage with cartilage damage and injury of the adjacent subchondral bone.

MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment

Osteochondral injuries are staged from I - V.  The displaced osteochondral fragment and cyst-like lesions beneath the fragment makes this a stage V injury.

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