osteochondral injury staging

Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.

  • stage I
    • injury limited to articular cartilage
    • MRI findings: subchondral edema
    • x-ray findings: none
  • stage II
    • cartilage injury with associated subchondral fracture but without detachment
    • thin sclerotic margin
    • x-ray findings: usually none; may see fracture as sclerotic or osteopenic area
    • two subtypes
      • type A: cystic on CT and/or edema on MRI
      • type B: non-displaced and incompletely undercut by fluid (MR) or lucency (CT), with an open connection to the articular cartilage (essentially 2a without edema on MRI)
  • stage III
    • detached, non-displaced fragment
    • MRI findings: high signal around osteochondral fracture (rim sign) but not displaced
    • x-ray findings: slight lucency between osteochondral fragment and remainder of the bone
  • stage IV
    • osteochondral fragment displaced
    • usually joint effusion present, surrounding fragment and filling donor site
    • x-ray findings: increased lucency between osteochondral fragment and remainder of the bone, or loose body with donor site irregularity
  • stage V
    • subchondral cyst formation
    • secondary degenerative change
    • x-ray findings: secondary osteoarthritis

See also

Siehe auch:
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