Validity of Ultrasound Compared with Magnetic Resonance Imaging in Evaluation of Osteochondritis Dissecans of the Distal Femur in Children

OBJECTIVE: Magnetic resonance imaging (MRI) is currently the gold standard to diagnose and monitor osteochondritis dissecans (OCD) of the knee. The purpose of this study was to evaluate for the first time if ultrasound imaging can be used to visualize osteochondritis dissecans of the distal femur.

DESIGN: From May 2008 to December 2013, 44 children (26 boys and 18 girls) presenting with OCD of the knee in our department were examined and evaluated by ultrasound imaging. Mean age at diagnosis was 11.8 ± 2.2 years. Two independent experienced orthopedic surgeons analyzed the localization, stage, and the size of the OCD via ultrasound and compared the results with the MRI findings.

RESULTS: Ultrasonic examination has limitations in assessing the OCD stage I and therefore is not suitable for evaluating this stage of the disease. In stages II to IV, a good correlation to MRI regarding defect localization and size can be found, when the defect is localized in a region that is accessible to ultrasonic examination.

CONCLUSION: Ultrasonic scan is an appropriate tool for the screening and monitoring of OCDs stages II to IV. It provides an inexpensive and readily available alternative to MRI. In addition, the healing process of higher grade defects as well as the screening of the opposite side can also be performed by ultrasound. Detection of defects being localized close to the intercondylar notch or far posterior on the lateral condyle are limitations for the use of ultrasound.