Ultrasound for Osteochondritis Dissecans

Overview

About this study

The goal of this proposal is to perform a pilot study in a group of patients (N=20) who have been diagnosed with osteochondritis dissecans (OCD) of the humeral capitellum. This pilot study will allow us to assess the study design, recruitment process, participant retention, and measurement variabilities for planning future large-scale studies.

Osteochondritis Dissecans (OCD) is a joint defect in which a crack forms in subchondral bone leading to separation of subchondral bone and overlying cartilage from the bulk of the bone. For this pilot study, we will be focusing on OCD within the elbow, specifically on the surface of the humeral capitellum. Large studies performed in Japan found that between 2.2-3.4% of youth baseball players develop OCD of the humeral capitellum. While ultrasound is a widely available, low cost, and non-ionizing imaging modality, it is not commonly used for assessing OCD lesions due to the limitations of Delay-and-Sum (DAS) reconstruction algorithms, which are widely used in clinical ultrasound scanners. Future studies will aim to determine if a new ultrasound reconstruction algorithm, called Delay-Multiply-and-Sum (DMAS), can address the current obstacles of using clinical ultrasound to diagnose severity and monitor healing of OCD lesions. Upon completion of these studies, geometric characteristics of OCD lesions will be reliably quantified to better assess their severity using ultrasound pre- and post-treatment. With improved reliability of diagnosis and monitoring, physicians will prevent advancement of OCD lesions to higher grades, as defined by the International Cartilage Regeneration and Joint Preservation Society (ICRS), and better determine the outcomes of their treatments without the use of ionizing radiation or higher cost of other imaging modalities. To accomplish this goal, we will recruit patients who have been diagnosed with OCD via X-ray computed tomography (CT) or Magnetic Resonance Imaging (MRI) and will be undergoing surgery to repair the condition. Patients will have their affected and contralateral elbows scanned using ultrasound once before surgery and at 6 weeks and 3 months after surgery. The ultrasound scans will be performed using both clinical and research ultrasound systems. The ultrasound scans acquired by the research system will be reconstructed using clinical-standard Delay-and-Sum (DAS) and the new DMAS algorithms. 

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Patients who are 10 to 45 years old and of both sexes.
  • Patients with a diagnosis of OCD of the capitellum ICRS Grades 3 or 4 via standard-of-care X-ray CT or MRI, irrespective of the size or location of the lesion.
  • Patients who are scheduled to undergo surgery for the treatment of the OCD lesion, irrespective of the procedure.

Exclusion Criteria: 

  • Patients with other current or prior elbow pathology.
  • Patients with prior history of elbow surgery.
  • Patients who do not consent to participate.

Eligibility last updated 9/3/21. Questions regarding updates should be directed to the study team contact.

 

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status

Rochester, Minn.

Mayo Clinic principal investigator

Shawn ODriscoll, M.D., Ph.D.

Closed for enrollment

More information

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