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Osteochondritis dissecans: Wilson's sign revisited
Jeffrey M Conrad1, Carl L Stanitski
1Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
The American Journal of Sports Medicine
|September 17, 2003
Summary
Wilson's sign has minimal diagnostic value for medial femoral osteochondritis dissecans. However, a positive Wilson's sign can indicate lesion healing during treatment.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Sports Medicine
Background:
- Wilson's sign, described in 1967, was proposed as diagnostic for medial femoral osteochondritis dissecans.
- The sign involves pain provocation with internal tibial rotation and relief with external rotation during knee extension.
- It was hypothesized that impingement of the tibial eminence on the lesion caused pain and compensatory gait changes.
Purpose of the Study:
- To evaluate the diagnostic accuracy and clinical utility of Wilson's sign.
- To determine if Wilson's sign is a reliable indicator of medial femoral osteochondritis dissecans.
Main Methods:
- Retrospective analysis of clinical and radiographic data.
- Review of case records for 32 juvenile and adolescent patients diagnosed with medial femoral osteochondritis dissecans.
- Assessment of Wilson's sign presence and absence at initial and follow-up visits.
Main Results:
- 75% (24 of 32) of patients with initial radiographic evidence of osteochondritis dissecans presented with a negative Wilson's sign.
- Eight patients with an initially positive sign showed conversion to negative as their lesions resolved.
- The sign's presence at initial diagnosis was not consistently observed.
Conclusions:
- Wilson's sign demonstrated minimal clinical diagnostic value for medial femoral osteochondritis dissecans in this patient cohort.
- A positive Wilson's sign can serve as a useful clinical indicator of treatment progress and lesion healing.