Grade Iiiii Lesions Partial Thickness Cartilage Injury

Grade II lesions represent fissures, erosion, ulceration, or fibrillation involving the superficial 50% of cartilage thickness. In the modified Outerbridge classification, lesions that extend to the deep 50% of cartilage are considered Grade III. These injuries can occur in the setting of acute trauma or secondary to remote injury. Acute injuries are suggested by the presence of adjacent soft-tissue edema, joint effusion, and bone marrow T2 hyperintensity. As discussed previously, chronic lesions are frequently heterogeneous, with areas of increased

Patella Median Ridge Axial

Fig. 5. Temporal changes in osteochondral injury: 18-year-old football player with blunt anterior knee trauma. (A) Axial fat-suppressed, PD-weighted FSE MRI demonstrates a bone marrow contusion in the medial patella, with heterogeneous elevated signal and surface irregularity of patellar cartilage overlying the median ridge. (B) MRI obtained 4 months postinjury demonstrates progressive loss of cartilage, with two full-thickness cartilage defects. Adjacent margins of the articular cartilage demonstrate decreased T2-weighted signal.

Fig. 5. Temporal changes in osteochondral injury: 18-year-old football player with blunt anterior knee trauma. (A) Axial fat-suppressed, PD-weighted FSE MRI demonstrates a bone marrow contusion in the medial patella, with heterogeneous elevated signal and surface irregularity of patellar cartilage overlying the median ridge. (B) MRI obtained 4 months postinjury demonstrates progressive loss of cartilage, with two full-thickness cartilage defects. Adjacent margins of the articular cartilage demonstrate decreased T2-weighted signal.

and decreased signal intensity on PD or T2-weighted FSE sequences. There is no general consensus in the MRI literature regarding terminology used to describe morphology of the cartilage lesions. Fissures represent linear clefts of the articular surface. They are most frequently observed acutely following joint trauma, particularly in patellar cartilage. As seen in Fig. 6, obliquely oriented fissures or flap tears can be seen as linear defects extending from the articular surface. Focal sites of cartilage loss can occur either as a result of remote cartilage injury, or in association with findings of osteoarthritis. Ulceration of superficial cartilage blisters results in a small focal irregular crater. Erosion refers to a smoothly marginated area of thinned cartilage, and is frequently seen in older patients. Cartilage erosion is often identified in the posterior tibial plateau and femoral condyle, particularly in patients who have chronic tears of the anterior cruciate ligament. Fibrillation or fraying of the articular surface appears visually as a fine velvety surface, and is a common finding in subjects who have oste-oarthritis. MRI has insufficient spatial resolution to resolve the individual fibrillations [38], and generally appears as an indistinct articular margin. Although MRI has poor correlation with arthroscopy for Outerbridge Grade I lesions (softening) of patella cartilage, sensitivity and specificity are greater than 85% for Grade II lesions and higher [79].

Was this article helpful?

0 -1
American Football 101

American Football 101

Are you looking for a way to increase the capabilities of your football team? Is your football team leaving something to be desired? Are you looking to skyrocket your team's effectiveness with the most effective drills and plays?

Get My Free Ebook


Responses

  • gregory luke
    What is grade 3 partial thickness cartilage loss with focal ulceration?
    7 months ago

Post a comment