Computerized blood flow analysis for decision making in the treatment of osteochondritis dissecans.

Patients presenting the radiologic appearance of osteochondritis dissecans (OCD) require a decision as to further treatment. This often requires an invasive procedure. The noninvasive technique of computerized blood flow analysis (CBFA) has been used in 13 patients with OCD. In clinically early disease (four patients), there is always decreased flow in the area distal to the OCD lesion. Patients with intermediate OCD (four patients) showed characteristics of healing reflected in increased flow to the OCD lesion. These patients were left under observation and underwent spontaneous healing. Patients who showed no increase in flow or had decreased flow in the area of involvement (four patients) were clinically found to be nonviable OCD and required surgical intervention. The technique of CBFA therefore holds promise for decision making in the management of this disease.