Osteochondritis Dissecans of the Knee at 7-T Trabecular Bone MRI

HomeRadiologyVol. 311, No. 3 PreviousNext Reviews and CommentaryFree AccessImages in RadiologyOsteochondritis Dissecans of the Knee at 7-T Trabecular Bone MRIZhiming Zhen, Wei Chen Zhiming Zhen, Wei Chen Author AffiliationsFrom the Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, The First Affiliated Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan St, Shapingba District, Chongqing 400038, China.Address correspondence to W.C. (email: [email protected]).Zhiming ZhenWei Chen Published Online:Jun 11 2024https://doi.org/10.1148/radiol.240048MoreSectionsPDF ToolsAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookXLinked In A 15-year-old male patient had recurrent right knee pain for over 2 years after experiencing a fall during a basketball game. Radiographs were normal. Dual-energy CT and 3-T MRI of the knee revealed subchondral bone marrow edema at the trochlear articular surface of the lateral femoral condyle and no abnormalities in the tendons, ligaments, or menisci (Fig 1). High-spatial-resolution gradient-recalled-echo trabecular bone MRI at 7 T (1) indicated discontinuity in the subchondral bone plate and intact overlying cartilage (Fig 2), consistent with stable osteochondritis dissecans (2). The adolescent was recommended to abstain from physical activities and wear a knee brace for a minimum of 6 weeks. After 3 months, the subchondral progeny fragment exhibited near-complete healing with surrounding parent bone (Fig 2), and the knee pain resolved. The findings from this case underscore the ability of 7-T MRI to offer information that is unattainable through conventional imaging.Figure 1: Initial imaging in a 15-year-old male patient with chronic right knee pain. (A) Anteroposterior radiograph shows normal findings. (B) Axial and (C) sagittal CT images with a voxel size of 0.4 × 0.4 × 0.4 mm show no apparent fracture. (D) Axial postprocessed virtual noncalcium image, (E) axial proton-weighted turbo spin-echo image at 3 T with a voxel size of 0.52 × 0.52 × 3.5 mm, and (F) sagittal T1-weighted turbo spin-echo image at 3 T with a voxel size of 0.45 × 0.45 × 3 mm demonstrate bone marrow edema of the lateral femoral condyle (arrow). Color scale in D, −150 to 100 HU.Figure 1:Download as PowerPointFigure 2: High-spatial-resolution 7-T MRI scans (A, C) before and (B, D) after treatment for osteochondritis dissecans of the knee. (A) The fracture line (arrow) is clearly visualized on the axial gradient-recalled-echo trabecular bone image with the following scan parameters: repetition time msec/echo time msec, 8.0/3.64; no fat suppression; flip angle, 15°; and voxel size, 0.1 × 0.1 × 0.8 mm. (C) Axial proton-weighted turbo spin-echo image with a voxel size of 0.1 × 0.1 × 2 mm demonstrates edema in the subchondral bone area (arrow). Corresponding (B) trabecular bone and (D) proton-weighted turbo spin-echo images at 3-month follow-up show near-complete fracture healing.Figure 2:Download as PowerPointDisclosures of conflicts of interest: Z.Z. No relevant relationships. W.C. No relevant relationships.AcknowledgmentsWe thank Wei Chen, PhD (MR Research Collaboration Teams, Siemens Healthineers), for providing technical support and Lin Guo, MD, PhD (Department of Sports Medicine, Southwest Hospital, Army Medical University), for constructive comments on the manuscript. These individuals were not compensated for these contributions.References1. Guenoun D, Pithioux M, Souplet JC, et al. Assessment of proximal femur microarchitecture using ultra-high field MRI at 7 tesla. Diagn Interv Imaging 2020;101(1):45–53. MedlineGoogle Scholar2. Gorbachova T, Amber I, Beckmann NM, et al. Nomenclature of subchondral nonneoplastic bone lesions. AJR Am J Roentgenol 2019;213(5):963–982. MedlineGoogle ScholarArticle HistoryReceived: Jan 9 2024Revision requested: Feb 5 2024Revision received: Feb 15 2024Accepted: Mar 5 2024Published online: June 11 2024 FiguresReferencesRelatedDetailsRecommended Articles Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRIRadioGraphics2018Volume: 38Issue: 5pp. 1478-1495Juvenile Osteochondritis Dissecans: Cartilage T2 Mapping of Stable Medial Femoral Condyle LesionsRadiology2018Volume: 288Issue: 2pp. 536-543Insights into the Epiphyseal Cartilage Origin and Subsequent Osseous Manifestation of Juvenile Osteochondritis Dissecans with a Modified Clinical MR Imaging Protocol: A Pilot StudyRadiology2016Volume: 282Issue: 3pp. 798-806Interpretation of Cartilage Damage at Routine Clinical MRI: How to Match Arthroscopic FindingsRadioGraphics2022Volume: 42Issue: 5pp. 1457-1473Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging PerspectiveRadiology2016Volume: 280Issue: 1pp. 21-38See More RSNA Education Exhibits Postoperative MR Imaging Of Cartilage Surgery Of The KneeDigital Posters2021The Importance of Knowing Normal: Review of Pediatric Knee Developmental Variants and Current Literature Update Regarding Clinical RelevanceDigital Posters2020Don't Be Afraid About T2 Mapping of the Knee Articular Cartilage: A Simple Way to Decrease Reports Ambiguity and Improve the Communication with ArthroscopistsDigital Posters2022 RSNA Case Collection Hoffa's fractureRSNA Case Collection2021Osteochondral lesionRSNA Case Collection2020Osteochondritis dissecansRSNA Case Collection2020 Vol. 311, No. 3 Metrics Altmetric Score PDF download