Knee Pathology
A 14-year-old competitive soccer player presents with 6 months of vague knee pain and intermittent swelling, worse with activity. Examination reveals mild effusion, no locking or catching, and full range of motion. X-rays show a well-defined radiolucent lesion in the lateral aspect of the medial femoral condyle (classic location). MRI demonstrates an intact overlying cartilage surface with no high T2 signal at the lesion-cartilage interface. The orthopedic surgeon diagnoses juvenile osteochondritis dissecans and discusses the distinction from adult OCD, assessment of lesion stability, non-operative treatment with activity modification, and indications for surgical intervention. Regarding osteochondritis dissecans of the knee:
Mark each as TRUE or FALSE
OCD is focal subchondral bone necrosis with overlying articular cartilage involvement; JUVENILE OCD ...
CLINICAL PRESENTATION: vague knee pain worse with activity, intermittent swelling, MECHANICAL SYMPTO...
OCD most commonly affects lateral femoral condyle (medial rare); juvenile OCD has worse prognosis th...
MRI STABILITY ASSESSMENT: STABLE lesion - intact overlying cartilage, NO high T2 signal at lesion-ca...
TREATMENT: JUVENILE STABLE lesions - NON-OPERATIVE first-line (activity modification, offloading, ob...
Answer the questions to see explanations
Click T (True) or F (False) for each option