May 2, 2023

This case of the week shows you intrachondral osteophytes. These are seen sometimes as auto-regeneration following focal defects or after microfracturing procedures. Other patients just seem to have a tendency to grow intrachondral ossifications. A. AP radiograph shows large intrachondral osteophytes at the medial femur and tibia (arrows) in this patient 10 years after ACL reconstruction. B. Sagittal DESS MRI shows intrachondral osteophytes at the anterior femur (arrows) and inferior patella (arrowhead). Note that the articular surface may arthroscopically be intact with a very thin layer of overlying intact cartilage. Such lesions are not covered by common MRI cartilage classifications.