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📌Causes of Osteochondral Defect
- Osteochondral defects can develop acutely from trauma or emerge as a chronic condition.
- They involve processes like the separation of fragments in OCD or bone collapse in SIF and AVN. Understanding these mechanisms is crucial for accurate diagnosis and treatment.
1️⃣ Trauma
- Cause: Direct impact or severe injury.
- Mechanism: Immediate separation of the osteochondral fragment.
- Note: "Osteochondral fracture" refers to subchondral bone depression or fragmentation.
2️⃣ Subchondral Insufficiency Fracture (SIF)
- Progression: Leads to collapse of the subchondral bone.
- Result: Noticeable defect in the bone structure.
3️⃣ Osteochondritis Dissecans (OCD)
- Mechanism: Detachment of a subchondral fragment leading to instability.
- Unique Feature: "Inside-out" mechanism, starting deep underneath the articular surface and extending to the cartilage.
- Clarification: Today, OCD refers exclusively to osteochondritis dissecans.
4️⃣ Avascular Necrosis (AVN)
- Cause: Collapse of necrotic bone.
- Result: Formation of an osteochondral defect.
5️⃣ Severe Osteoarthritis
- Cause: Chronic wear and tear.
- Result: Significant attrition leading to osteochondral defects.
References
- AJR 2019; 213:963–982
- RadioGraphics 2018; 38:1478–1495
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
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#OsteochondralDefects, #ArticularCartilage, #SubchondralBone, #Trauma, #SubchondralInsufficiencyFracture, #OsteochondritisDissecans, #AvascularNecrosis, #SevereOsteoarthritis, #InsideOutMechanism, #OutsideInMechanism
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