Abstract
The knee is the joint which is most commonly imaged by MRI in children and adolescents. With increasing participation in competitive sports, traumatic knee injuries with osteochondral lesions are increasingly common in children. However, it is also important to exclude non traumatic conditions that result in defects of the articular cartilage and/or subchondral bone plate or growth plate of the knee, since timely diagnosis and therapy may help prevent lifelong disability in these patients. Moreover, there are normal variants that occur in the ossifying knee that should not be mistaken for lesions. The aim of this essay is to review the wide range of conditions that may result in MRI signal changes of the ossifying knee in children.
Highlights
The knee is the joint which is most commonly imaged by Magnetic resonance imaging (MRI) in children and adolescents
A high T2 signal intensity rim surrounding a juvenile Osteochondritis dissecans (OCD) lesion indicates instability if it has the same signal intensity as adjacent joint fluid, if it is surrounded by a second outer rim of low T2 signal intensity, or if it is accompanied by multiple breaks in the subchondral bone plate on T2weighted images
Since no single MRI feature can differentiate septic from non septic arthritis, biopsy may be warranted in the work-up of these lesions [18,19,20]
Summary
Fig. 1. — Chondral fracture in an 11-year-old boy. A. — Chondral fracture in an 11-year-old boy. A. Coronal T1-weighted image demonstrates a large loose body (arrows) with signal intensity f cartilage in the femorotibial joint space. B. Sagittal T1-weighted image demonstrates the avulsed osteochondral fragment (arrows) anteriorly in the femorotibial joint space. These lesions are often subtle but can be significant clinically and may remain undetected. It is important to include MRI sequences that are sensitive to articular cartilage injury in the evaluation of internal derangement of the paediatric knee [4]
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