Background: Osteochondral lesions of the knee-a lesion of the subchondral bone that may involve partial or total separation of a fragment of the articular cartilage and the subchondral bone from the articular surface -is an increasingly recognized cause of knee pain and joint dysfunction. The aim of this study is to discuss the highresolution MRI with its new evolving sequences, highlighting its pivotal role in evaluation and characterization of different morphological patterns, and pathological types of osteochondral lesions around the knee joint. Methods: This study included 50 patients, all were subjected to full history taking, complete clinical assessment and MRI assessment. Results: This study included 32 (64%) males and 18 (36%) females. According to age there were 13 (26%) with age less than 30, 7 (14%) with age ranged from 30 to 40, 12 (24%) from 40 to 50 and 18 (36%) with age more than 50 years with mean age 42.96 (±17.29) and range . The sensitivity of MRI in diagnosis of Osteochondral Lesions around the Knee was 95%, specificity was 76.7%, PPV was 86.3%, NPV was 96.4% and accuracy was 92%, Conclusion: MRI has the advantage of not utilizing ionizing radiation and gives a superior detail state of cartilage, the underlying bone plates, associated edema, signs of instability. This could be guide for treatment as well as the diagnosis, and could be used as prognostic indicator for the disease process. In our opinion, MRI is golden tool for diagnosis, classification and follow up of osteochondral lesion.
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