(Fig 5-B.22) MRI Findings of Osteochondritis Dissecans

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MSK MRI Jee Eun Lee

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📌 MRI Findings of Osteochondritis Dissecans

✅ Key MRI Findings

1. High Signal Intensity Rim
   Observed at the interface between the fragment and the adjacent bone on T2-weighted sequences.
2. Fluid-filled Cysts
   Presence of fluid-filled cysts beneath the lesion.
3. High Signal Intensity Line
   A high signal intensity line extending through the articular cartilage overlying the lesion.
4. Focal Osteochondral Defect
   A defect filled with joint fluid, indicating complete detachment of the fragment.

 

✅ Additional MRI Observations

• Subchondral Bone Irregularity
  On MR images, OCD appears as an irregularity of the subchondral bone with underlying marrow edema-like signal intensity.
• Secondary Physis Disruption in Children
  MRI of children with OCD consistently showed secondary physis disruption, overlying chondroepiphyseal widening, and subchondral bone edema.

 

✅ Disease Progression

As the disease progresses, fragmentation and detachment of the subchondral bone are observed. Interestingly, this process of osteochondral fragmentation begins in the deep portion under the articular surface and eventually involves the superficial articular cartilage, suggesting an “inside-out” mechanism.

 

References

• Radiopaedia: Osteochondritis Dissecans
• Japanese Journal of Radiology (2022) 40:443–457
• AJR 2019; 213:963–982
• AJR 2012; 199:1121–1128

 

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#OsteochondritisDissecans, #MRI, #Radiology, #SubchondralBone, #T2Weighted, #Cartilage, #BoneEdema, #PhysisDisruption, #PediatricRadiology, #MedicalImaging