MRI Features That Contribute to Decision-Making for Treatment of Capitellar OCD Lesions: An Expert Consensus Using...

Area of Science:

• Orthopedic Surgery
• Radiology
• Medical Imaging

Background:

• Magnetic resonance imaging (MRI) is crucial for diagnosing and managing osteochondritis dissecans (OCD) of the capitellum.
• A lack of consensus exists regarding specific MRI features that provide clinically relevant information for capitellar OCD.
• Standardizing MRI interpretation is essential for consistent clinical decision-making.

Purpose of the Study:

• To establish consensus on salient MRI features for clinical decision-making in capitellar OCD using a Delphi protocol.
• To identify MRI characteristics that predict lesion stability and potential for nonoperative healing.

Main Methods:

• A 3-round Delphi survey was administered to 33 identified experts in capitellar OCD.
• Participants rated the clinical importance of 33 MRI features for decision-making.
• Agreement and consensus thresholds were set at ≥66%.

Main Results:

• Seventeen of 33 MRI features reached expert agreement for clinical importance.
• High consensus was achieved for features indicating lesion stability (100%) and instability (100%).
• Consensus was also reached on features predicting nonoperative healing potential (94%) and low healing potential (88%).

Conclusions:

• A Delphi process successfully generated consensus on clinically relevant MRI features for capitellar OCD.
• These findings will form the basis for an interrater reliability study and a standardized MRI assessment tool.
• Developing a standardized tool aims to enhance clinical practice and improve patient outcomes for capitellar OCD.