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Osteochondral Injury, Elbow
Donna G. Blankenbaker, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Osteochondral lesion (OCL)
            • Osteochondral fracture
            • Osteochondritis dissecans (OCD)
            • Osteochondral defect
            • Panner disease
          • Definitions

            • Osteochondral abnormality of subchondral bone that involves overlying articular cartilage; likely arises as result of genetic predisposition, repetitive stress/overuse, inflammation, ischemia, or some combination
            • OCD
              • Chronic osteochondral injury of capitellum due to repetitive injury from valgus forces
              • Adolescent throwers and tumblers
              • Findings overlap with acute osteochondral fracture
              • Because of lack of primary inflammatory component, osteochondral defect is more descriptive of this condition
              • OCD remains term used for this lesion in classic clinical setting
            • Osteochondral fracture
              • Term for acute injuries (as opposed to OCD)
              • Thinner fragment of articular cartilage and subchondral bone
            • Panner disease
              • Controversial etiology: disordered cartilage growth vs. traumatic injury
              • Young children
              • Radiographic irregularity of entire capitellum growth center
              • Self-limited; usually remodels by adulthood
            • OCL: all-encompassing preferred term that refers to osteochondral defects, osteochondral fractures, and vascular insufficiency lesions of subchondral bone

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Collins MS et al: Osteochondral lesions of the lateral trochlear ridge: a rare, subtle but important finding on advanced imaging in patients with elbow pain. Skeletal Radiol. 49(4):593-99, 2020
                                        2. Matsuura T et al: Osteochondritis dissecans of the capitellum: review of the literature. J Med Invest. 67(3.4):217-21, 2020
                                        3. Logli AL et al: Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm. Curr Rev Musculoskelet Med. 12(1):1-12, 2019
                                        4. Wang KK et al: Osteochondritis dissecans of the humeral trochlea: characterization of a rare disorder based on 28 cases. Am J Sports Med. 47(9):2167-73, 2019
                                        5. Ellermann JM et al: Magnetic resonance imaging of osteochondritis dissecans: validation study for the ICRS classification system. Acad Radiol. 23(6):724-9, 2016
                                        6. Nissen CW: Osteochondritis dissecans of the elbow. Clin Sports Med. 33(2):251-65, 2014
                                        7. Zbojniewicz AM et al: Imaging of osteochondritis dissecans. Clin Sports Med. 33(2):221-50, 2014
                                        8. Jans LB et al: MR imaging findings and MR criteria for instability in osteochondritis dissecans of the elbow in children. Eur J Radiol. 81(6):1306-10, 2012
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Pathology

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Osteochondral lesion (OCL)
                                                  • Osteochondral fracture
                                                  • Osteochondritis dissecans (OCD)
                                                  • Osteochondral defect
                                                  • Panner disease
                                                • Definitions

                                                  • Osteochondral abnormality of subchondral bone that involves overlying articular cartilage; likely arises as result of genetic predisposition, repetitive stress/overuse, inflammation, ischemia, or some combination
                                                  • OCD
                                                    • Chronic osteochondral injury of capitellum due to repetitive injury from valgus forces
                                                    • Adolescent throwers and tumblers
                                                    • Findings overlap with acute osteochondral fracture
                                                    • Because of lack of primary inflammatory component, osteochondral defect is more descriptive of this condition
                                                    • OCD remains term used for this lesion in classic clinical setting
                                                  • Osteochondral fracture
                                                    • Term for acute injuries (as opposed to OCD)
                                                    • Thinner fragment of articular cartilage and subchondral bone
                                                  • Panner disease
                                                    • Controversial etiology: disordered cartilage growth vs. traumatic injury
                                                    • Young children
                                                    • Radiographic irregularity of entire capitellum growth center
                                                    • Self-limited; usually remodels by adulthood
                                                  • OCL: all-encompassing preferred term that refers to osteochondral defects, osteochondral fractures, and vascular insufficiency lesions of subchondral bone

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Collins MS et al: Osteochondral lesions of the lateral trochlear ridge: a rare, subtle but important finding on advanced imaging in patients with elbow pain. Skeletal Radiol. 49(4):593-99, 2020
                                                                              2. Matsuura T et al: Osteochondritis dissecans of the capitellum: review of the literature. J Med Invest. 67(3.4):217-21, 2020
                                                                              3. Logli AL et al: Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm. Curr Rev Musculoskelet Med. 12(1):1-12, 2019
                                                                              4. Wang KK et al: Osteochondritis dissecans of the humeral trochlea: characterization of a rare disorder based on 28 cases. Am J Sports Med. 47(9):2167-73, 2019
                                                                              5. Ellermann JM et al: Magnetic resonance imaging of osteochondritis dissecans: validation study for the ICRS classification system. Acad Radiol. 23(6):724-9, 2016
                                                                              6. Nissen CW: Osteochondritis dissecans of the elbow. Clin Sports Med. 33(2):251-65, 2014
                                                                              7. Zbojniewicz AM et al: Imaging of osteochondritis dissecans. Clin Sports Med. 33(2):221-50, 2014
                                                                              8. Jans LB et al: MR imaging findings and MR criteria for instability in osteochondritis dissecans of the elbow in children. Eur J Radiol. 81(6):1306-10, 2012