Magnetic Resonance Imaging in Osteochondritis Dissecans of the Humeral Capitellum: Preoperative Assessment of Lesion Size and Lateral Wall Integrity

2021 ◽  
Author(s):  
J. Sam Broughton ◽  
Mitchel R. Obey ◽  
Travis J. Hillen ◽  
Matthew V. Smith ◽  
Charles A. Goldfarb
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Preoperative Assessment ◽  
Lateral Wall ◽  
Lesion Size ◽  
Resonance Imaging

scholarly journals Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging

2019 ◽  
Vol 12 (4) ◽  
pp. 284-293 ◽  
Author(s):  
Rens Bexkens ◽  
F. Joseph Simeone ◽  
Denise Eygendaal ◽  
Michel PJ van den Bekerom ◽  
Luke S Oh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Interobserver Agreement ◽  
Interobserver Reliability ◽  
Lateral Wall ◽  
Magnetic Resonance Images ◽  
Resonance Imaging ◽  
Instability Criteria

Aim (1) To determine the interobserver reliability of magnetic resonance classifications and lesion instability criteria for capitellar osteochondritis dissecans lesions and (2) to assess differences in reliability between subgroups. Methods Magnetic resonance images of 20 patients with capitellar osteochondritis dissecans were reviewed by 33 observers, 18 orthopaedic surgeons and 15 musculoskeletal radiologists. Observers were asked to classify the osteochondritis dissecans according to classifications developed by Hepple, Dipaola/Nelson, Itsubo, as well as to apply the lesion instability criteria of DeSmet/Kijowski and Satake. Interobserver agreement was calculated using the multirater kappa (k) coefficient. Results Interobserver agreement ranged from slight to fair: Hepple (k = 0.23); Dipaola/Nelson (k = 0.19); Itsubo (k = 0.18); DeSmet/Kijowksi (k = 0.16); Satake (k = 0.12). When classifications/instability criteria were dichotomized into either a stable or unstable osteochondritis dissecans, there was more agreement for Hepple (k = 0.52; p = .002), Dipaola/Nelson (k = 0.38; p = .015), DeSmet/Kijowski (k = 0.42; p = .001) and Satake (k = 0.41; p < .001). Overall, agreement was not associated with the number of years in practice or the number of osteochondritis dissecans cases encountered per year (p > .05). Conclusion One should be cautious when assigning grades using magnetic resonance classifications for capitellar osteochondritis dissecans. When making treatment decisions, one should rather use relatively simple distinctions (e.g. stable versus unstable osteochondritis dissecans; lateral wall intact versus not intact), as these are more reliable.

Autologous Osteochondral Mosaicplasty for Centrally and Laterally Located, Advanced Capitellar Osteochondritis Dissecans in Teenage Athletes: Clinical Outcomes, Radiography, and Magnetic Resonance Imaging Findings

2018 ◽  
Vol 46 (8) ◽  
pp. 1943-1951 ◽  
Author(s):  
Tadanao Funakoshi ◽  
Daisuke Momma ◽  
Yuki Matsui ◽  
Tamotsu Kamishima ◽  
Yuichiro Matsui ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcomes ◽  
Osteochondritis Dissecans ◽  
Case Series ◽  
Return To Play ◽  
Joint Surface ◽  
Resonance Imaging ◽  
Level Of Evidence

Background: Autologous osteochondral mosaicplasty (ie, mosaicplasty) results in satisfactory clinical outcomes and reliable return to play for patients with large or unstable lesions due to osteochondritis dissecans (OCD) of the humeral capitellum. However, the association between the healing of the reconstructed cartilage and clinical outcomes remains unclear. Purpose: To evaluate the efficacy of mosaicplasty in teenage athletes through use of clinical scores and imaging. The secondary purpose was to compare the clinical outcomes with images of centrally and laterally located lesions. Study Design: Case series; Level of evidence, 4. Methods: This study analyzed 22 elbows (all male patients; mean age, 13.5 ± 1.2 years) with capitellar OCD managed with mosaicplasty. Patients were divided into 2 groups according to the location of the lesions: central (10 patients) and lateral (12 patients). Evaluation was performed through use of the clinical rating system of Timmerman and Andrews, plain radiographs, and magnetic resonance imaging (MRI; the cartilage repair monitoring system of Roberts). The mean follow-up period was 27.5 months (range, 24-48 months). Results: Lateral lesions were significantly larger than central lesions (147.1 ± 51.9 mm2 vs 95.5 ± 27.4 mm2, P = .01). No other significant differences were found between central and lateral lesions. Timmerman and Andrews scores for both central and lateral lesions improved significantly from 125.0 ± 30.1 points and 138.3 ± 34.5 points preoperatively to 193.5 ± 11.3 points and 186.7 ± 18.1 points, respectively, at final follow-up ( P < .0001, P < .0001). Radiography identified complete graft incorporation in all cases and the absence of severe osteoarthritic changes or displaced osteochondral fragments. In the lateral group, the radial head ratio at final follow-up (1.83 ± 0.23) was significantly larger than the preoperative findings (1.75 ± 0.14, P = .049). The quality of joint surface reconstruction was found to be acceptable for central and lateral lesions on MRI evaluation. Conclusion: Mosaicplasty resulted in satisfactory clinical outcomes and smooth cartilage surface integrity in teenage athletes with OCD on their return to competition-level sports activities irrespective of lesion location.

Magnetic resonance imaging in 120 patients with intractable partial seizures: a preoperative assessment

2005 ◽  
Vol 47 (5) ◽  
pp. 352-361 ◽  
Author(s):  
A. Lefkopoulos ◽  
A. Haritanti ◽  
E. Papadopoulou ◽  
D. Karanikolas ◽  
N. Fotiadis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Preoperative Assessment ◽  
Resonance Imaging ◽  
Partial Seizures

Fixation of Unstable Osteochondritis Dissecans Lesions and Displaced Osteochondral Fragments Using New Biodegradable Magnesium Pins in Adolescents

Cartilage ◽  
2020 ◽  
pp. 194760352094294
Author(s):  
Oliver D. Jungesblut ◽  
Menard Moritz ◽  
Alexander S. Spiro ◽  
Ralf Stuecker ◽  
Martin Rupprecht
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Intraoperative Complications ◽  
X Rays ◽  
Resonance Imaging ◽  
Short Term ◽  
Pediatric Orthopedic ◽  
Time Of Operation ◽  
Biodegradable Magnesium

Objective Fixation of unstable osteochondritis dissecans (OCD) lesions and displaced osteochondral fragments are frequently performed procedures in pediatric orthopedic surgery. Since 2018, CE-certified MAGNEZIX pins are used in our institution in these cases. The aim of this study was (1) to analyze safety, efficiency, and limitations of magnesium-pin-based fixation of unstable OCD lesions and displaced osteochondral fragments and (2) to report clinical and radiological outcomes at short-term follow-up (FU). Design In this prospective cohort study, 19 patients (10 girls and 9 boys) were included. Inclusion criteria were (1) magnetic resonance imaging–confirmed unstable OCD lesion or displaced osteochondral fragment, (2) fixation with magnesium-based pins, and (3) minimum FU of 6 months. X-rays were taken 6 weeks and 6 months after operation and magnetic resonance imaging scans every 4 to 6 months to assess the healing progress. Results In total 67 pins were used, with a mean of 3.6 ± 1.4 per patient. Average age at surgery was 13.7 years (11-17 years). Mean time of operation was 56 ± 31 minutes, including arthroscopy, fixation, and patellar realignment ( n = 6). No intraoperative complications occurred. Average FU was 11.3 ± 4.2 months (6-20 months). No redislocation or new dislocation occurred. Until now a complete radiographic healing occurred in 12 cases. Due to an implant failure in one case 11 weeks after the index surgery a revision became necessary. Conclusions In short-term FU of 11 ± 4 months MAGNEZIX pins provide high stability after fixation of unstable OCDs and displaced osteochondral fragments leading to uncomplicated and timely healing.

Endoanal magnetic resonance imaging of fistula‐in‐ano: a comparison of stir with gadolinium‐enhanced techniques

2005 ◽  
Vol 46 (1) ◽  
pp. 3-8 ◽  
Author(s):  
T. A. Szyszko ◽  
J. Bush ◽  
P. Gishen ◽  
D. Sellu ◽  
N. M. DeSouza
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Phased Array ◽  
Preoperative Assessment ◽  
Kappa Statistic ◽  
Fisher Exact Test ◽  
Internal Opening ◽  
Resonance Imaging ◽  
Stir Sequence ◽  
Endoanal Magnetic Resonance Imaging

Purpose: To compare a STIR sequence with gadolinium‐enhanced techniques on endoanal magnetic resonance (MR) imaging of fistulas‐in‐ano by correlating the findings with those at surgery. Material and Methods: Twenty‐two consecutive patients with clinical suspicion of perianal sepsis were studied using an endoanal coil followed immediately by a phased array coil. T1‐weighted precontrast and postcontrast and STIR images in transverse and coronal planes were produced with each coil and analysed by noting the presence and site of a collection, primary track, the position of any internal opening, and subcutaneous or supralevator extension. An “expert” and also a “trainee” radiologist assessed the images. Operative findings were similarly recorded. The Fisher exact test was used to compare imaging with surgery. Interobserver variation was calculated using a kappa statistic. Results: Of 22 patients with suspected fistulas, 8 were simple, 4 were complex, and 3 were superficial sinuses. Five had no anal pathology, 1 had anal excoriation, and 1 had a polyp. At surgery, 6 intersphincteric, 1 transsphincteric, 8 extrasphincteric, no supralevator collections, and 9 internal openings were noted. The overall sensitivity and specificity for detecting these were 75% and 64%, respectively, for STIR imaging, and 58.3% and 62.8% for gadolinium‐enhanced imaging. There was good agreement between the “trainee” and the “expert” in the interpretation of images (kappa = 0.7). Conclusion: A STIR sequence is more sensitive overall than gadolinium‐enhanced techniques on endoanal magnetic resonance imaging of fistulas‐in‐ano because of increased sensitivity in detecting the internal opening. A combination of endoanal and phased array techniques using STIR imaging sequences is valuable preoperative assessment in both simple and complex cases.

Sign in / Sign up

Export Citation Format

Share Document