Nguyen Jie C, Patel Vandan, Gendler Liya, Blankenbaker Donna G, Shea Kevin G, Wall Eric J, Carey James L, Nissen Carl W, Jaramillo Diego, Ganley Theodore J
Musculoskeletal Section, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Skeletal Radiol. 2025 Apr;54(4):789-806. doi: 10.1007/s00256-024-04749-6. Epub 2024 Aug 13.
Osteochondritis dissecans (OCD) describes a pathologic condition centered at the osteochondral junction that may result in an unstable subchondral fragment (progeny), disruption of the overlying cartilage, which may separate from the underlying parent bone. It is one of the causes of chronic knee pain in children and young adults. The current literature on OCD lesions focuses primarily on the medial femoral condyle (MFC), but inconsistent use of terminology, particularly in the distinction of OCD lesions between skeletally immature and mature patients has created uncertainty regarding imaging workup, treatment, and long-term prognosis. This article reviews the pathophysiology of MFC OCD lesions, highlighting the role of endochondral ossification at the secondary growth plate of the immature femoral condyles, the rationale behind the imaging work-up, and key imaging findings that can distinguish between stable lesions, unstable lesions, and physiologic variants. This overview also provides a case-based review to introduce imaging correlates with the ROCK (Research in Osteochondritis of the Knee) arthroscopic classification.
剥脱性骨软骨炎（OCD）是一种以骨软骨交界处为中心的病理状况，可能导致不稳定的软骨下碎片（子代），覆盖其上的软骨发生破坏，软骨可能与下方的母骨分离。它是儿童和年轻成人慢性膝关节疼痛的原因之一。目前关于OCD病变的文献主要集中在股骨内侧髁（MFC），但术语的不一致使用，特别是在骨骼未成熟和成熟患者的OCD病变区分上，给影像学检查、治疗和长期预后带来了不确定性。本文回顾了MFC OCD病变的病理生理学，强调了未成熟股骨髁二级生长板处软骨内成骨的作用、影像学检查的基本原理以及可区分稳定病变、不稳定病变和生理变异的关键影像学表现。本综述还提供了基于病例的回顾，以介绍与ROCK（膝关节骨软骨炎研究）关节镜分类相关的影像学表现。
