Early adulthood
Common in posteromedial (frequently asymptomatic, no histroy of trauma) or anterolateral aspect (symtomatic, history of trauma)
Surgical grading:
Grade 1: Smooth-intact-soft articular cartilage
Grade 2: Rough surface
Grade 3: Flibrillation and fissures
Grade 4: Loose, but undisplaced
Grade 5: Displaced
Arthroscopic grading:
Grade 1: Intact firm and shiny cartilage
Grade 2: Soft intact cartilage
Grade 3: Frayed cartilage
Plain film staging:
Stage 1: Subchondral compression
Stage 2: Partially detatched
Stage 3: Completely detatched, but undisplaced
Stage 4: Detached
CT staging:
Stage 1: Cystic lesion with intact roof
Stage 2a: Cystic lesion communicating with the roof
Stage 2b: Open articular surface
Stage 3: Undisplaced with surrounding lucency
Stage 4: Displaced
MR Grading:
Grade 1: Subchondral trabecular compression
Grade 2a: Subchondral cyst with intact dome
Grade 2b: Incomplete separation
Grade 3: Fluid around undisplaced fragment
Grade 4: Displaced
References:
Stoller text book
SCHENCK RC et al. Current Concept Review - Osteochondritis Dissecans. The Journal of Bone and Joint Surgery 78:439-56 (1996)
