title: Classification and assessment of juvenile osteochondritis dissecans knee lesions.
abstract: OBJECTIVE
  Juvenile osteochondritis dissecans (JOCD) knee lesions are common abnormalities in adolescents and children, and have higher rates of spontaneous healing with nonoperative management compared to adult osteochondritis dissecans (OCD) lesions. Multiple classification and assessment systems have been established in order to help clinicians determine which lesions are amenable to nonoperative management. However, these assessments often use adult OCD classification systems of lesion stability, which have poor reliability in JOCD lesions. The purpose of this review is to assess these various classification systems proposed for JOCD lesions.
  
  
  RESULTS
  Although arthroscopy remains the gold standard for the definitive assessment of lesion stability, recent evidence suggests that MRI characteristics indicative of instability in adult OCD lesions are not applicable in determining JOCD lesion instability. In addition, the correlation between arthroscopic and MRI indications of instability is highly varied in these younger patients.
  
  
  CONCLUSIONS
  In order for the pediatric orthopedic surgeon to more accurately predict treatment outcomes in patients with JOCD knee lesions, further investigation into the radiographic characteristics specific to JOCD lesion instability and healing is warranted.
authors.affiliation: aWeill Cornell Medical College bHospital for Special Surgery, New York, NY, USA.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Uppstrom
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Gausden
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Green
mesh_terms: D001182:Arthroscopy / Q000379:methods; D002648:Child; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D010008:Osteochondritis Dissecans / Q000145:classification* / Q000175:diagnosis*; D011859:Radiography; D012720:Severity of Illness Index