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Plain radiographs can reliably classify features of osteochondritis dissecans in the knee
Recently published data indicated plain radiographs helped reliably classify a number of diagnostic features of femoral condyle osteochondritis dissecans.
Seven blinded orthopedic/sports medicine raters retrospectively reviewed the pretreatment anteroposterior, lateral and notch radiographs of 42 patients with 45 symptomatic knees in containing medial or femoral condyle osteochondritis dissecans (OCD) lesions. The physicians rated knees over a secure web portal twice during the span of a month, evaluating variables such as lesion location, growth plate maturity, parent bone radiodensity, progeny bone fragmentation, bone displacement and bone contour, as well as lesion boundary and the radiodensity of the lesion rim and center. The researchers measured condyle width and lesion size. Utilizing free-marginal kappa, the researchers also evaluated interrater reliability, and Cohen kappa was used to assess intrarater reliability and intraclass correlations based on type of measurement.
According to the researchers, both the interrater and the intrarater had excellent reliability when differentiating medial and lateral lesions, maturity of the growth plate, measurements condylar width and the size of the lesion.
The raters classified visible bone in lesion, fragmentation and displacement, boundary, central radiodenisty and lesion bone contour with moderate-to-substantial reliability. Additionally, the lesion rim and epiphyseal bone surrounding were classified with poor-to-fair reliability. – by Monica Jaramillo
Disclosure: The study was supported by the AOSSM Smith & Nephew Grant.