The clinical utility and diagnostic performance of MRI for identification and classification of knee osteochondritis dissecans.
BACKGROUND
Magnetic resonance imaging (MRI) is a common clinical tool used to diagnose and monitor the progression and/or healing of osteochondritis dissecans of the knee. The purpose of this study was to systematically review the literature relative to the following questions: (1) Is MRI a valid, sensitive, specific, accurate, and reliable imaging modality to identify knee osteochondritis dissecans compared with arthroscopy? (2) Is MRI a sensitive tool that can be utilized to characterize lesion severity and stability of osteochondritis dissecans fragments in the knee?


METHODS
A systematic search was performed in December 2010 with use of PubMed MEDLINE (from 1966), CINAHL (from 1982), SPORTDiscus (from 1985), Scopus (from 1996), and EMBASE (from 1974) databases.


RESULTS
Seven studies, four Level-II and three Level-III investigations, met the specified inclusion criteria. No randomized controlled studies were identified. Because of inconsistencies between imaging techniques and methodological shortcomings of many of the studies, a meta-analysis was not performed.


CONCLUSIONS
The limited available evidence, methodological inconsistencies in imaging techniques, and lack of standardized grading criteria used in current studies prevent clear conclusions regarding the diagnostic and specific staging equivalency of MRI with arthroscopy. However, available evidence supports the use of MRI to detect the stability or instability of the lesion. Given the benefits of the use of MRI as a noninvasive tool to diagnose, predict lesion progression, and assess clinical outcomes of treatment, there is a pressing need for high-level, systematic, sound, and thorough studies related to the clinical utility of MRI for assessing osteochondritis dissecans of the knee.
Ohio State University Medical Center, Columbus, USA. Carmen.quatman@gmail.com
Carmen E
CE
Quatman
Catherine C
CC
Quatman-Yates
Laura C
LC
Schmitt
Mark V
MV
Paterno
D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D010008:Osteochondritis Dissecans / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index