Introduction
Osteochondritis dissecans (OCD) is a localised disorder of subchondral hone and the overlying articular cartilage. The most commonly used classification systems involve arthroscopy and MRI.
Aim
To investigate the correlation between arthroscopic and MR findings in patients with OCD of the talus.
Methods
16 ankles in 14 patients with radiographically proven OCD were reviewed. Nine were male and five female. Mean age was 35yrs (range 18-64yrs). The lesions were staged independently using the Guhl1 arthroscopic and Dipaola2 MR classification systems.
Results
Arthroscopically there were eight stable and eight unstable lesions. Of the eight stable lesions. MRI staged five as stable and three as unstable. Of the eight unstable lesions. MRI staged six as unstable and two as stable. This gives a sensitivity of diagnosing unstable lesions as 0.75, with a specificity of 0.63.
Conclusions
This small study demonstrates that MR scans may have some limitations in classifying OCD lesions of the talus. Possible explanations are discussed. We propose that MRI findings, of OCD of the talus, should not be taken in isolation, but correlated with the patients symptoms and signs to avoid unnecessary arthroscopy.
(1) Guhl JF. Arthroscopic treatment of osteochondritis dissecans. Clin Orthop (167)65-74, 1982
(2) DiPaola J, Nelson DW, Colville M. Characterising osteochondral lesions by magnetic resonance imaging. Arthroscopy (7)101-4, 1991
N W Emms, S J Scott, HPJ Walsh, B Eyes.
Aintree University Hospital, Lower Lane, Liverpool L9 7AL. wiksy@aol.com
Copyright British Editorial Society of Bone & Joint Surgery 2003
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