Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Case 19 Pseudodefect of the capitellum versus osteochondral defect
- Case 20 Pseudodefect of the trochlear groove versus fracture
- Case 21 Transverse trochlear ridge versus osteophyte or post-traumatic deformity
- Case 22 FABS positioning on MRI: demonstration of distal biceps tear
- Case 23 Ulnar collateral ligament tear versus normal recess of the elbow
- Case 24 T-sign of undersurface partial tear of the ulnar collateral ligament
- Case 25 Lateral ulnar collateral ligament tears
- Case 26 Locations and evaluation of loose bodies in the elbow joint
- Case 27 Osteochondritis dissecans of the elbow: stable versus unstable
- Case 28 Little Leaguer’s elbow: what is it?
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Case 27 - Osteochondritis dissecans of the elbow: stable versus unstable
from Section 3 - Elbow
Published online by Cambridge University Press: 05 July 2013
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Case 19 Pseudodefect of the capitellum versus osteochondral defect
- Case 20 Pseudodefect of the trochlear groove versus fracture
- Case 21 Transverse trochlear ridge versus osteophyte or post-traumatic deformity
- Case 22 FABS positioning on MRI: demonstration of distal biceps tear
- Case 23 Ulnar collateral ligament tear versus normal recess of the elbow
- Case 24 T-sign of undersurface partial tear of the ulnar collateral ligament
- Case 25 Lateral ulnar collateral ligament tears
- Case 26 Locations and evaluation of loose bodies in the elbow joint
- Case 27 Osteochondritis dissecans of the elbow: stable versus unstable
- Case 28 Little Leaguer’s elbow: what is it?
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Summary
Imaging description
On radiography and CT, osteochondritis dissecans of the elbow is seen as a dome-shaped or somewhat circular-shaped lucency in the mid- or lateral aspect of the capitellum (Figure 27.1). However, in the advanced stage, it will be seen as a divot on the articular surface of the capitellum with a loose body/displaced fragment. The advanced stage of osteochondritis dissecans, will appear similarly on MRI. The earlier stages of osteochondritis dissecans without a loose body will appear as a dome-shaped, curvilinear lesion with a surrounding rim of low signal intensity on T1-weighted images with variable, heterogeneous signal intensity within the lesion. On T2-weighted images, lesions that are stable will also have a rim of low signal intensity and central heterogeneous, variable signal. However, when earlier lesions (those without fragment displacement) are unstable, they will have an intense rim of high signal on T2 or high signal cystic changes at the rim (Figure 27.2).
Importance
On MRI, it is important to identify stable lesions with an adjacent open distal humeral physis because these can be treated successfully with conservative therapy. The size of the lesion is also important as this can drive the type of surgical treatment (debridement with resection versus reconstruction of the injury – such as with osteochondral autograft transplantation surgery).
- Type
- Chapter
- Information
- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 55 - 57Publisher: Cambridge University PressPrint publication year: 2013