TABLE I.

Diagnostic Performance of MRI Relative to Arthroscopy for Osteochondritis Dissecans (OCD) Lesions in the Knee

Study	Grading System	Magnet Strength (T)	MRI and Arthroscopy Blinding	Temporal*	Compartments Analyzed	Diagnostic Performance	Comments
Hughes et al.12(Level II)	Modifications of Pritsch et al.18, Dipaola et al.11, Kramer et al.19, and Bohndorf23	1.0	Radiologist blinded to clinical information, radiographs, and arthroscopy; surgeon aware of MRI initial results.	2 mo to 2 yr; majority within 6 mo	Medial femoral condyle (12 knees), lateral femoral condyle (7 knees), lateral tibial plateau (1 knee), and patella (1 knee)	100% correlation for stability of the lesion; 55% (6/11) were not correctly graded by MRI; 72% were correctly graded, with MRI performed within 4 mo of arthroscopy.	Retrospective cohort of 19 patients (5-15 years old) with 21 knees evaluated by both MRI and arthroscopy; not stated if patients were consecutive.
Hung and Huang15(Level III)	Not established	1.5	Not reported	Not reported	Medial and lateral femoral condyles	Sensitivity and specificity not reported; 100% accuracy could be calculated for identifying unstable lesion.	Retrospective (not stated if consecutive) study of 11 patients with OCD (7 in knee), only 5 had comparison with arthroscopy; established diagnostic criteria of OCD lesions were not described and, thus, study downgraded to Level III.
Kijowski et al.13(Level II)	De Smet et al.20	1.5-3.0	Radiologists blinded to arthroscopy report.	Within 58 d; mean, 21.7 d	Medial femoral condyle (49), lateral femoral condyle (16), and lateral femoral trochlea (5)	100% sensitivity if all criteria used to determine stability, specificity of 11% for juvenile OCD and 100% for adult for determining stability; further information about secondary MRI findings	Retrospective, consecutive study of 65 patients who had both MRI and arthroscopy performed on symptomatic knee with suspected OCD lesion; 34 adult OCD lesions and 36 juvenile OCD lesions.
Kocher et al.16(Level III)	Not reported	1.5	Radiologist not blinded to diagnosis. MRI and reports were available to surgeons.	Not reported	Not reported	Sensitivity of 90.9%, specificity of 97.9%, positive predictive value of 69.5%, and negative predictive value of 99.5% for identifying OCD lesion	Retrospective, consecutive study identified 22 knee OCD lesions in patients with intra-articular knee disorders; established diagnostic criteria of OCD lesions were not described and, thus, study downgraded to Level III.
Luhmann et al.17(Level III)	Not reported	1.5	Radiologist not blinded to diagnosis. Surgeon not blinded to radiology report.	Not reported	Not reported	Sensitivity of 77.8%, specificity of 94.9%, positive predictive value of 77.8%, and negative predictive value of 94.9% for identifying OCD lesion	Prospective, consecutive study of adolescent knees, 19 OCD lesions; established diagnostic criteria of OCD lesions were not described; and, thus, study downgraded to Level III.
O'Connor et al.14(Level II)	Dipaola et al.11 for MRI and Guhl21 for arthroscopy	0.5	Radiologist blinded to arthroscopy results. Not stated if surgeon blinded.	1-58 wk; mean, 18 wk	Not reported	45% of original MRI reports accurately predicted arthroscopy grade; re-report of MRI with Dipaola system resulted in 85% accurate prediction of arthroscopy grade.	Retrospective study of patients who had MRI and arthroscopy of suspected OCD lesions; 33 knees in 31 patients were identified (age range, 6-15 yr; mean, 11.8 yr).
Dipaola et al.11(Level II)	Modification of Berndt and Harty22	0.35	Prospective blinded radiographic classification performed by radiologist.	Within 7 wk	Medial femoral condyle	All but 1 of 6 lesions correctly staged.	Prospective, not stated if consecutive (therefore downgraded to Level-II evidence), double-blind study of 14 patients (6 knees examined)

^*Temporal refers to the time between MRI and arthroscopy.