Elbow ultrasound of capitellar osteochondritis dissecans
Capitellar osteochondritis dissecans (COCD) typically occurs in adolescent athletes who are engaged in throwing sports that repetitively stress the immature capitellum, although the exact etiology remains unclear. The choice of treatment for COCD mainly depends on the patient’s age and characteristics of the lesion, including its size and fragment instability. Evaluating the stability of the osteochondral fragment is important when choosing surgical versus non-surgical treatment options. Stable lesions are more likely to heal with elbow rest, whereas surgery provides better results for unstable lesions. Preoperative assessment is based on clinical findings in combination with imaging results. The article of Yoshizuka et al. (2017) compared MRI and ultrasound (US). The US criteria in this study correctly matched the International Cartilage Repair Society classification in 23 of 24 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the US diagnoses were 92%, 100%, 100%, 92%, and 96%, respectively. The outcome was that US achieved superior accuracy compared with MRI.