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]. focal defect of the articular cartilage and sub-chondral bone (Fig. 23.1 (a–c) MRI and arthroscopic images demonstrating trochlear and radial head lesions (arrows) (a, c: Reprinted from Jans LBO et al. It is the result of repetitive impaction and shear forces. 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. It is the result of repetitive impaction and shear forces. This would be the optimal scenario. Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. MRI findings on the articular side of the OCD lesion included osteochondral defect, intraarticular body, overly-ing cartilage changes, and … 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]. The staging, prognosis, and treatment of osteochondral lesions in the elbow are based on a combination of radiographic, magnetic resonance imaging, and arthroscopic findings. Injury results in delamination and potential sequestration of the affected bone. 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]. cartilage injury with associated subchondral fracture but without detachment 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. MR imaging findings and MR criteria for instability in osteochondritis dissecans of the Osteochondral autograft transplantation or mosaicplasty provides autologous hyaline articular cartilage. Although an association with mechanical and traumatic factors has b … Fig. The radiograph is of a 15 year old baseball player with 4 year history of elbow pain and a recent episode of locking. Red arrows point to osteochondral defect and bone edema on T1 and stir MRI images of the knee in same patient as above. 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). 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. An osteochondral defect that is in the early stages may be suitable for a repair technique to keep the native bone and cartilage. The chronic valgus overload can cause an osteochondral lesion on the lateral side of the elbow. Osteochondritis dissecans of medial femoral condyle-ovoid fragment of bone is separated from surface of condyle but does not yet lie freely within the joint. 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