(Fig 5-B.23) ICRS Staging System of Osteochondritis Dissecans

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MSK MRI Jee Eun Lee

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📌ICRS Staging System of Osteochondritis Dissecans

• The International Cartilage Repair Society (ICRS) grading system is adapted for MRI to clinically and arthroscopically evaluate osteochondritis dissecans (OCD).
• As OCD progresses, fragmentation and detachment of the subchondral bone are observed. 
• This process of osteochondral fragmentation starts in the deep portion under the articular surface and eventually involves the superficial articular cartilage, suggesting an "inside-out" mechanism.

 

✅ Stage 1 OCD

• Description: Stable lesion in continuity with the host bone and covered by intact articular cartilage.
• Imaging: The cartilage appears continuous with the bone, and no significant fragmentation is visible.

 

✅  Stage 2 OCD

• Description: Stable lesion showing partial discontinuity of the cartilage from the host bone.
• Imaging: Partial separation of the cartilage from the underlying bone is observed, indicating some degree of instability.

 

✅  Stage 3 OCD

• Description: Unstable lesion showing complete discontinuity of the "dead in situ" lesion. However, the fragment is not dislocated.
• Imaging: A clear gap between the lesion and the host bone, but the fragment remains in place.

 

✅  Stage 4 OCD

• Description: Presence of an osteochondral defect with a dislocated fragment.
• Imaging: The lesion is completely separated from the host bone, with the fragment displaced.

 

References

• J Clin Orthop Trauma. 2021 Sep 25;22:101610
• Japanese Journal of Radiology (2022) 40:443–457

 

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#ICRS #OCD #OsteochondritisDissecans #Radiology #MRI #Arthroscopy #CartilageRepair #BoneFragmentation #MedicalImaging #Orthopedics