Pediatric emergency medicine trisk 3961 3961
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FIGURE 121.12 Osteochondritis dissecans of the medial femoral condyle. Crescentic lesion
with radiolucent margin in a 14-year-old girl.
Early lesions may not be detected on plain films, and alternate imaging
modalities may improve overall sensitivity. When correlated with arthroscopic or
surgical findings, MRI has been shown to have excellent ability to detect
osteochondritis dissecans and accurately define the extent and stage of the lesion (
Fig. 121.13 ). Osteochondritis dissecans lesions are staged according to the
degree of separation from the underlying bone. Stage three or four lesions by
MRI have significant separation and are considered unstable. Most orthopedic
surgeons consider MRI useful in distinguishing JOCD from other pathologic
conditions, guiding therapy and monitoring healing.
