The role of MRI in elbow osteochondritis dissecans: correlations with intraoperative findings and implications for clinical management

Osteochondritis dissecans (OCD) of the elbow is common in adolescent athletes, causing functional impairment. This study examined the clinical, imaging, and intraoperative characteristics of OCD lesions, evaluating MRI's diagnostic and prognostic value, and identifying factors affecting recovery. The study included 119 athletes, 22 with confirmed OCD. Data on demographics, clinical features, and MRI findings were collected, along with preoperative assessments and outcomes (time to return to sport and QuickDASH scores). MRI lesion size correlated with intraoperative measurements (<i>r</i> = 0.81, <i>p</i> < 0.001) but was poor at assessing stability (<i>r</i> = -0.088, <i>p</i> = 0.696). Larger lesions and lateral wall involvement were associated with instability and prolonged recovery. Factors like lesion size, Tanner Stage III, and left-handed dominance were linked to OCD risk. Larger lesions predicted delayed recovery. MRI is useful for lesion characterization but limited in predicting stability and outcomes. Early detection and management are crucial for optimal recovery.