MRI can reliably detect and stage osteochondritis disse-cans; however, the accuracy of staging is improved by performing MR arthrography using dilute gadolinium.40 Unstable lesions are characterized by fluid or contrast encircling the osteochondral fragment on T2-weighted images. Loose in situ lesions also may be diagnosed by identifying a cystlike lesion beneath the osteochondral fragment.41 These cystlike lesions typically contain loose granulation tissue at surgery, which explains why they may enhance after intravenous administration of gadolinium (Fig. 4.9). Few authors have reported their experience with intravenous gadolinium-enhanced scans to evaluate osteonecrosis and osteochondritis dissecans in the elbow.42
Osteochondritis dissecans should be distinguished from osteochondrosis of the capitellum, which is known as Panner's disease. Panner's disease is characterized by fragmentation and abnormally decreased signal intensity within the ossifying capitellar epiphysis on the T1-weighted images similar in appearance to Legg-Calve-Perthes disease in the hip. Panner's disease is believed to represent avascular necrosis of the capitellar ossification center that occurs secondary to trauma. Subsequent scans reveal normalization of these changes with little or no residual deformity of the capitellar articular surface. The articular surface typically remains intact and does not undergo fragmentation or loose-body formation.
Was this article helpful?
Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.