title: MR imaging findings and MR criteria for instability in osteochondritis dissecans of the elbow in children.
abstract: OBJECTIVE
  Osteochondritis dissecans (OCD) of the elbow is an uncommon cause of elbow pain in adolescents and occurs at different locations in the elbow joint. Early diagnosis and treatment may prevent surgery. The aim of the study is to describe the MR imaging features of OCD at initial imaging, and to correlate these findings with surgical findings of stability and instability with arthroscopic findings as the reference standard.
  
  
  METHODS
  Patients were identified through a keyword search of the radiology information system from 2000 to 2009. Twenty-five patients (26 elbows) with OCD of the elbow were identified (age 10.4-18 years, mean age 14 years). MR studies were retrospectively reviewed by two radiologists in consensus to define MR imaging findings and to determine the presence of previously described MR imaging criteria for OCD instability (i.e., high T2 signal rim, surrounding cysts, high T2 signal fracture line, fluid-filled osteochondral defect). Sensitivity of the individual and combined criteria was calculated.
  
  
  RESULTS
  OCD occurred in the capitellum in 24 patients (92%), in the trochlea in 2 patients (8%) and radial head in 1 patient (4%). Loose bodies were identified in 11 (42%) patients. Eighteen patients demonstrated MRI findings in keeping with unstable lesions. In all 11 patients who had surgery the surgical findings of instability correlated with the MRI findings. When combined, the MR criteria were 100% sensitive for instability of OCD lesions of the elbow.
  
  
  CONCLUSIONS
  The vast majority of OCD of the elbow occurs in the capitellum. When used together, the MR criteria for instability were 100% sensitive for evaluation OCD lesions of the elbow.
authors.affiliation: Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. lennartjans@hotmail.com
authors.forename: Lennart B O
authors.initials: LB
authors.lastname: Jans
authors.forename: Michael
authors.initials: M
authors.lastname: Ditchfield
authors.forename: Gomez
authors.initials: G
authors.lastname: Anna
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Jaremko
authors.forename: Koenraad L
authors.initials: KL
authors.lastname: Verstraete
mesh_terms: D000293:Adolescent; D001182:Arthroscopy; D002648:Child; D004551:Elbow Joint / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010008:Osteochondritis Dissecans / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity