Because of the nonspecific nature of the clinical signs and symptoms of OCD, imaging plays a central role in the diagnosis and prognosis of this disease. The role of the different imaging modalities has evolved with time. The incidence of OCD has been estimated to be between 0.02% and 0.03% by radiography, and as high as 1.2% by arthroscopy. Onset is between childhood and middle age, with the majority of patients being between 10 and 40 years of age, with approximately a 2:1 male to female ratio 3. Emerging MRI sequences have shown great potential for the physiologic assessment of cartilage repair tissue. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Although the radiographic examination can establish the diagnosis of OCD correctly, it is not adequate for prognostic and therapeutic decisions. The impending separation of the osteochondral fragment is in keeping of grade III lesion. Although not the focus of this discussion, other joints that can be affected include the ankle, elbow, hip, and wrist. Special interest was placed on the assessment of fragment stability with radiological methods for staging … These MRI criteria include (1) a rim of high signal intensity surrounding an OCD lesion on T2-weighted images (hereafter referred to as high T2 signal intensity), (2) cysts surrounding an OCD lesion, (3) a fracture line of high T2 signal intensity extending through the articular cartilage overlying an OCD lesion, and (4) a fluid-filled osteochondral defect. 180, no. The overall accuracy of MR findings in determining the staging was 90% (37 of 41) for reader 1 and 83% (34 of 41) for reader 2. Potential limitations of such sequences include their long acquisition times as well as their susceptibility to metal artifacts, which may be an important consideration after surgery. Imaging modalities used for assessment of OCD include conventional radiography, nuclear medicine, computed tomography (CT), CT arthrography, magnetic resonance imaging (MRI), and magnetic resonance (MR) arthrography. Two classes of pulse sequence acquisition have been most widely used in this regard: intermediate and T2-weighted fast spin echo (FSE) techniques, and three-dimensional (3D) spoiled gradient echo (SPGR) or fast low-angle shot (FLASH) sequences. The classic location for OCD in the knee is the posterolateral aspect of the medial femoral condyle (69%). This process results in an arthrogramlike effect and highlights the usually low-intermediate signal cartilage. Recently, Kijowski and colleagues proposed revised criteria for OCD instability based on skeletal maturity of the patient. 1 Bachmann G, Jurgensen I, Siaplaouras J. The ultimate cause of OCD lesions is unknown at this time, but is likely multifactorial, with mechanical causal factors being most important. Objective: To assess the diagnostic performance of combined three-dimensional (3D) gradient-echo (GRE) T1-weighted and routine MR imaging protocol for the evaluation of osteochondritis dissecans (OCD). 3 ). The etymology of the term osteochondritis dissecans is worthy of discussion. Osteochondritis dissecans can be classified at surgery into 4 stages: stage I. stable; lesion in continuity with the host bone; covered by intact cartilage; stage II. The dGEMRIC imaging technique, which displays the distribution of negatively charged gadolinium-based MRI contrast material (gadopentetate dimeglumine) within cartilage, has been validated as an accurate marker of cartilage tissue glycosaminoglycan (GAG) concentration. 20. 1 ). Initial radiographic evaluation of patients with suspected OCD should include anterior-posterior (AP), lateral, tunnel, and skyline views. J. Roentgenol. 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