In 1966, Osborne and Cotterill reported on recurrent dislocation of the elbow and described “an osteochondral fracture in the posterolateral margin of the capitellum with or without a crater or shovel-like defect in the radial head” as the main abnormality of this condition. the elbow joint that displaced both the anterior and posterior fat pads partially or completely out of the coronoid and olecranon fossae. Osteochondral autograft transplantation or mosaicplasty provides autologous hyaline articular cartilage. 3). Factors such as repetitive trauma and valgus stress in the elbow are believed to be a cause for OCL of the elbow, though the exact aetiology is not clear [2]. The staging, prognosis, and treatment of osteochondral lesions in the elbow are based on a combination of radiographic, magnetic resonance imaging, and arthroscopic findings. An osteochondral defect (p = 0.01), intraarticular body (p < 0.001), overlying cartilage changes (p = 0.001), subchondral bone plate disruption (p = 0.02), and hyperintense rim (p = 0.01) were significantly more common in unstable than stable OCD lesions. MRI findings on the articular side of the OCD lesion included osteochondral defect, intraarticular body, overly-ing cartilage changes, and … Although an association with mechanical and traumatic factors has b … focal defect of the articular cartilage and sub-chondral bone (Fig. MR imaging findings and MR criteria for instability in osteochondritis dissecans of the Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. In this procedure, osteochondral plugs are harvested from non–weight-bearing areas such as the lateral femoral condyle or the trochlea and transplanted in an articular defect in the same person (, Fig 2) (, 8, , 19,, 20,, 24). This would be the optimal scenario. cartilage injury with associated subchondral fracture but without detachment It is the result of repetitive impaction and shear forces. Red arrows point to osteochondral defect and bone edema on T1 and stir MRI images of the knee in same patient as above. The radiograph is of a 15 year old baseball player with 4 year history of elbow pain and a recent episode of locking. This requires a detailed evaluation to be performed to assess the integrity of the remaining cartilage, the underlying bone and to look for evidence of healing capacity. 23.1 (a–c) MRI and arthroscopic images demonstrating trochlear and radial head lesions (arrows) (a, c: Reprinted from Jans LBO et al. Osteochondral defects may be the result of acute traumatic injury, subchondral collapse, or displacement of an unstable fragment in patients with osteochon-dritis dissecans [31]. It is the result of repetitive impaction and shear forces. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. Injury results in delamination and potential sequestration of the affected bone. The chronic valgus overload can cause an osteochondral lesion on the lateral side of the elbow. Osteochondral lesion (OCL) of the elbow can affect different structures of the joint, but is most frequent in the anterolateral part of capitulum humeri [1]. Osteochondral lesion is the new name for osteochondritis dissecans or OCD. 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