Multiple Osteochondritis Dissecans of Knee Joint in a Patient with Wilson Disease, Focusing on Magnetic Resonance Findings

Abstract

both knees in a patient with Wilson disease. Case ReportA 17-year-old man visited our orthopedic department with an acute attack of the left knee pain that had begun 2 days previously.The patient had experienced discomfort in both knees for the previous 7 months.A physical examination revealed diffuse swelling and tenderness of the left knee and motion limitation due to pain.Positive Wilson sign was evident and there seemed no other joint involvement but the both knees.The patient had no record of previous medical history or family history of other diseases.Plain radiography was performed, which revealed symmetrical multiple OCD on femoral condyles of both knees (Fig. 1).Further evaluation was warranted for the unusual presentation of the disease.The patient was admitted and had a routine laboratory test prior to admission and it was his first time to take laboratory tests.His laboratory tests showed thrombocytopenia platelet count of 83×10 3 /µL, prolonged prothrombin (PT)/activated partial prothrombin time (aPTT) of 14.7/45.3sec.Further lab tests were carried out, and revealed deficit of coagulation factors V, XI, and XII (all 44%; normal range, 60% to 140%).Abdominal ultrasound revealed cirrhotic morphologic changes of the liver and splenomegaly.A suspicion of Wilson disease led to more