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The Clinical Utility and Diagnostic Performance of MRI for Identification and Classification of Knee Osteochondritis Dissecans

Quatman, Carmen E. MD, PhD; Quatman-Yates, Catherine C. PT, DPT, PhD; Schmitt, Laura C. PT, MPT, PhD; Paterno, Mark V. PT, PhD, SCS, MBA, ATC

Journal of Bone & Joint Surgery - American Volume: 6 June 2012 - Volume 94 - Issue 11 - p 1036–1044
doi: 10.2106/JBJS.K.00275
Scientific Articles
Supplementary Content

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.

Level of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

1Department of Orthopaedic Surgery (C.E.Q.), Sports Health and Performance Institute (C.E.Q. and L.S.), and Division of Physical Therapy, School of Health and Rehabilitation Services (L.S.), Ohio State University, 2050 Kenny Road, Suite 3100, Columbus, OH 43221. E-mail address for C.E. Quatman: Carmen.quatman@gmail.com

2Human Performance Laboratory at the Sports Medicine Biodynamics Center (C.C.Q.-Y. and M.P.), Department of Pediatrics (M.P.), and Division of Occupational Therapy and Physical Therapy (C.C.Q.-Y. and M.P.), Cincinnati Children’s Hospital Medical Center, 3333 Burnett Avenue, Cincinnati, OH 45229

Copyright 2012 by The Journal of Bone and Joint Surgery, Incorporated
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