Wikipedia:Featured article candidates/Osteochondritis dissecans


 * The following is an archived discussion of a featured article nomination. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured article candidates. No further edits should be made to this page.

The article was promoted by Raul654 10:55, 9 March 2009.

Osteochondritis dissecans

 * Nominator(s): FoodPuma

I am nominating this for featured article because after a successful GA nomination, 2 peer reviews and support by colleagues I believe this article is genuinely FA material. It's sole concern at this point is that the article may be too technical for a general audience. I believe we, as a community, can work this issue out during the FAC process and any other kinks that may be raised. Cheers! FoodPuma 23:57, 15 February 2009 (UTC)

Comment - this contribution is, in part, an educational assignment. Graham Colm Talk 00:17, 16 February 2009 (UTC)

Comment  As the article is part of the WikiProject AP Biology 2008; to which I am involved, it would be inappropriate to state support. However, the aforementioned concern over technical level is of interest. Hopefully, this FA attempt will not become a battle ground over the philosophical merits of technical accuracies vs. accessibility. When compared to other articles of a medical nature, this entry seems no more or less complex. The use of extensive linking to the appropriate resources; even to the point of creating sub-articles or stubs when nothing existed, offers the reader the opportunity to educate themselves where necessary.--JimmyButler (talk) 00:23, 16 February 2009 (UTC)

Comments -
 * Current ref 6 (Adolescent ...) needs a publisher. Author if known would be good.
 * The article was uploaded by a user "Matt" so I used that as the first name of the Author. Not really sure what to do in this type of situation, so feel free to change remove author name if that is inapproriate. Publisher added. (Note: this is now ref #14, as it did not needed to be included in intro and was removed there.) FoodPuma 18:35, 16 February 2009 (UTC)


 * Same for current ref 43 (Adolescent...)
 * Same here, publisher was added but author is "user: Matt." (Note, now ref #44 b/c of added horse citation in signs/symptoms). FoodPuma 18:35, 16 February 2009 (UTC)


 * What makes http://emedicine.medscape.com/ a reliable source?
 * The Editorial Board listed on the page linked. Graham Colm Talk 14:47, 16 February 2009 (UTC)


 * Current ref 52 (Autologus...) is lacking a publisher
 * Added publisher (Medscape) Graham Colm Talk 19:18, 16 February 2009 (UTC)


 * Sources in non-English languages need to be noted as such.
 * Noted as such. Graham Colm Talk 19:12, 16 February 2009 (UTC)
 * Otherwise, sources look okay, links checked out with the link checker tool. Ealdgyth - Talk 14:40, 16 February 2009 (UTC)

 Conditional Support - for now. The words "patient" and "patients" are used extensively in the article which gives the impression that the target audience are medical professionals. WP:MOSMED advises against this— see WP:MOSMED. I know this is often difficult to avoid (and we do not want "victim" or even "sufferer") but please try to use "people" or "person" whenever possible, or even "teenager". Yes, I agree that some readers will find this a difficult article to understand because of the technical terms. Again this is hard to avoid, but more of an effort should be made on the Lead section. Those readers with only a passing interest will probably only want to read this section. I think Prognosis would be better placed before Epidemiology, but this is no big deal in my book. I am particularly impressed with the references both in quality and quantity. Having watched this article develop since the project began last year, I am even more impressed with the result and that the article has been brought to the level of a FAC. I would like to see more comments from our medical colleagues (this is not my field) before adding my full support. In the interim, well-done, this is a fine achievement. Graham Colm Talk 20:59, 16 February 2009 (UTC)
 * I have addressed these issues WP:BOLD →, please check that I haven't introduced errors and please indicate the location of studies, (US, UK etc) where appropriate. There is at least one. Graham Colm Talk 22:08, 19 February 2009 (UTC)


 * Opposed on jargon (in lede). If you expect a random reader to know what osteochondritis means in the lede, you're on the wrong site. The article on osteochondritis is merely a WP:DICTDEF stub that's not too much trouble to explain in this FA. The lede needs to present the information in an accessible order/fashion. We're talking about an inflamation here not some difficult concept that would be unwieldy to explain. Xasodfuih (talk) 23:37, 16 February 2009 (UTC)
 * The order of the sections is also problematic. You could put history first since it's not too long to get tiresome, and it helps understanding the rest of the article; stuck between epidemiology and veterinary is rather odd. Classification should probably come after diagnostic, since it's based on MRI etc. The current layout discusses subtype subtleties before general info (signs and symptoms). Xasodfuih (talk) 23:56, 16 February 2009 (UTC)
 * Mind you, these issues have already been pointed out, but seemingly ignored in Peer_review/Osteochondritis_dissecans/archive2. Xasodfuih (talk) 00:03, 17 February 2009 (UTC)
 * Comment: For medical articles there is an agreed and well-established order; please see WP:MOSMED. Graham Colm Talk 00:09, 17 February 2009 (UTC)
 * Which you have obviously not read: "Establishing the forms of the disease (Classification) can be an important first section. However, if such classification depends heavily on understanding the etiology, pathogenesis or symptoms, then that section may be better moved to later in the article. If a disease is incurable, then the Prognosis section can be moved up and a section called Management is more appropriate than Treatment.". Xasodfuih (talk) 00:23, 17 February 2009 (UTC)
 * (Edit conflict) I have read the guidelines many times. It was the comment about the placement of the History section that I did not agree with. The placement of this section in an FA has been debated many times, and although I do not always agree, I think it is not fair to oppose on this issue. Having said this, I agree that there are the problems of jargon in the lead section.Graham Colm Talk 00:37, 17 February 2009 (UTC)
 * I do not feel strongly about the placement of the history section; it appears odd to me sandwiched like that however. I'm more concerned with the classification section diving too abruptly in minutiae, which is why I quoted the above MOS stuff. Xasodfuih (talk) 18:17, 17 February 2009 (UTC)
 * Reply:I too agree with the necessity of a "dumbed-down" lead section after reading your comments. Thank you for pointing out some serious flaws that require my attention, Xasodfuih. Its getting a little late now, so when I get home from school tomorrow I will attempt some revisions of the lead. Hopefully I may sway you, should I complete the necessary edits in a timely fashion. Again, thanks for reiterating a point that I should not have disregarded in the first place. FoodPuma 02:59, 17 February 2009 (UTC)
 * Update: This version alleviates my concerns. Neutral/Not supporting yet because I've been busy with another review to keep track of what was going on here. Xasodfuih (talk) 06:55, 20 February 2009 (UTC)


 * Support. Although the article contains some technical language, the intro as it currently exists would be comprehensible to most readers. --Arcadian (talk) 22:56, 18 February 2009 (UTC)
 * I almost agree and I don't think that the article should be "dumbed-down" at all. Short definitions after, "subchondral bone" for example, is all that is needed. Links often help, but if a phrase is all that is needed, then just include one. It is important to remember that many readers still have slow internet connections and the time taken for links to load can be frustratingly slow. This is such a good contribution, and the more I read it, the more tempted I am to remove my "conditional". Graham Colm Talk 23:44, 18 February 2009 (UTC)


 * I am particularly unhappy about the new position of the History section. I don't see any good reason why it should be so near to the start of the article. This is a deviation from the recommended WP:MOSMED guideline. If Xasodfuih or other editors have a problem with the guideline's recommendation, please take it to the talk page there. Axl  ¤  [Talk]  07:48, 19 February 2009 (UTC)
 * Huh? I see it's the last section now, which is fine. I made a mere suggestion about the history section; like I said above, I did not feel strongly about it (nor did I make the change). Xasodfuih (talk) 06:52, 20 February 2009 (UTC)

Comment: There's a sentence fragment in the lead ("Sometimes with the formation of loose bodies of cartilage and/or bone within the joint space."). I probably won't review this article, as it's too far outside my areas of interest, but I wanted to at least note that. Sarcasticidealist (talk) 15:34, 19 February 2009 (UTC)
 * Graham Colm addressed these issues in his recent edit. Thank you for contributing, however! FoodPuma 23:07, 19 February 2009 (UTC)

Oppose pending resolution of the following. The article is packed with good information, but often the connections are not made. That is so-called telegraphic writing. Readers familiar with the subject know the connections; some educated readers will be able to infer the connections;  many readers will have no clue what is understood but not said, or make wrong inferences. When I finished reading the intro I had no clear idea what OCD was; I think I now understand, but I had to make a lot of inferences. I still don't know quite what growth plates have to do with OCD. The big picture needs to be brought out in the lede, and in intro paragraphs within the major sections. --Una Smith (talk) 07:47, 20 February 2009 (UTC)


 * The lede explains osteochondritis but not dissecans. The reader is left to deduce that dissecans refers to dissection.  The name of a medical condition often is best "unpacked" in an etymology section, the first section of the article.  Some of the third paragraph, beginning with Franz König, can go in the etymology section.


 * "Below the joints" is unclear. Many people have a mental image of bones and it does not include growth plates.  I think the article needs to introduce growth plates even earlier than it does now (in the second paragraph) and state explicitly their role in OCD.


 * Some of the third paragraph, the part about confusing OCD with other conditions, perhaps should be put in the diagnosis section. The reader is left wondering about the difference between osteochondritis and osteochondrosis.  Also, if in the past OCD was confused with other conditions, that implies those conditions form what MDs call a "differential diagnosis" where the task is to isolate OCD from those other conditions.  What are the key details that distinguish OCD from each of these other conditions?


 * Reply: I disagree with you on the topic of your first and third bullets. I, personally, find an etymology section both unnecessary and possibly detrimental (in that it reiterates information found elsewhere in the article [for example, Franz Konig in the history section] ). Elaborating on the difference between osteonecrosis and OCD as a result of ostenoecrosis (or avascular necrosis, whichever you prefer) would also only serve to confuse the reader by requiring them to read detailed information on the difference - knowing that "A" does not equal "B", but "A" is a result of "B" is enough to satisfy most readers. With that out of the way, I will agree that growth plates should perhaps be explained in it's role: that bone and cartilage typically heal faster/better when the growth plates of an individual are open (since the bone is still actively growing.) FoodPuma 22:14, 20 February 2009 (UTC)
 * (Edit conflict) You beat me to it, I fully concur with this response to the review. Graham Colm Talk 20:44, 20 February 2009 (UTC)


 * I think it should be noted that the suggestions of your third bullet, while in good faith, seem to oppose the general debate above concerning article technicality. Also, I wanted to point out that, in response to your first bullet, I have chosen to use a more appropriate definition from The American Association of Family Physicians. It does a better job of differentiating between the definition of the two words (osteochondritis and dissecans) and the definition of (osteochondritis dissecans) - the sum is greater than it's parts. Also, thank you for stopping by my talk page and explaining your reasons for opposing. I appreciate your time invested in reviewing the article. FoodPuma 20:29, 20 February 2009 (UTC)


 * The lede is much better now. The prior version gave the idea that open growth plates contribute to OCD;  now it says they contribute to recovery.  I am suggesting pulling together the etymology, which is now distributed between the intro and the history, not duplicating content in those sections.  I think this would resolve some discomfort that other reviewers have had with the location of the history section.  I was startled by the history section at the end, even though that is where medicine articles usually have it.  I think my startle was because the section has some content, a sentence or two, that should come earlier.  If confusion of OCD with other conditions is a point of historical interest only, then doesn't it belong in the history section?  Does it really merit mention in the lede?  In a long bone the "subchondral bone" is the epiphysis, the bone that lies between the joint articular cartilage and the epiphyseal plate/line?  Please define subchondral bone somewhere.  Perhaps in Epiphysis with a redirect?  --Una Smith (talk) 00:54, 21 February 2009 (UTC)
 * Reply: I quote you (Una) as saying the following: "Please define subchondral bone somewhere." This can be found in the second line of the lede, and I quote, "OCD affects the subchondral bone, which is beneath the cartilage surface of joints..." Also, should that not suffice, "subchondral" is explcitely wikilinked later on Pathophysiology . Your argument for important information in the history section has merit, however users referencing that section will find it readily accessible via the "Contents" menu. Also, just as I explained how the epiphysis (growth plate) is an important part in recovery in the lede, I never mention it's importance again. Likewise, I explain the confusion of terms in the lede, but it does not merit reiteration or movement to a different or possibly new section. By including the material in the lede, we have assured the casual reader will read it (or is at least more likely to read it) instead of putting it an etymology section. By the way, I don't believe most casual readers will understand what "etymology" means unless they are an english major, teacher, high school/college/grad school student or professor in some field concerning the languages. It is not common knowledge. FoodPuma 01:57, 21 February 2009 (UTC)
 * There are a couple of style issues here: see Lead section and MOSMED.  Is "subchondral" limited to a thin margin under the articular cartilage?  Or does it extend to the epiphyseal line?  State "articular cartilage" because that is what Wikipedia calls it.  I would use the bone diagram in the article, right below the infobox. --Una Smith (talk) 03:11, 21 February 2009 (UTC)
 * You will find the recent edits I made after Jakob.scholbach's suggestions has improved the lede dramatically. I believe the concept is quite fully explained in an accessibly way without sacrificing conciseness. If you have the time, might I suggest reading over the new lede to see if it has addressed your concerns. Thank you. FoodPuma 21:54, 4 March 2009 (UTC)


 * The lede continues to improve, but still needs more work. On the article talk page Graham Colm has asked that references not be used only in the lede.  I agree.  Those references, and any information not also in the body of the article, should be moved to the body and not mentioned in the lede at all.  Reserve the lede for the most important information.  Information not important enough to be discussed in the body does not belong in the lede.  I fixed a couple of links to dab pages today, along with a lot of other work on the article and related articles, but a link remains to Anomalies.  I have asked before about the role of epiphyseal plates in OCD.  The article mentions them, which implies they have some role and therefore that the entire epiphysis is somehow involved.  I now understand they have none, and I have edited Epiphysis to mention of the other growth zone (not a plate) on the epiphysis:  the subchondral bone.  The article about OCD might be improved by some careful rewording re this important distinction, or at least not linking to Epiphyseal plate in the manner that it does now. --Una Smith (talk) 06:22, 9 March 2009 (UTC)


 * I fail to see how your most recent edit is even beneficial, Una. Of course, I say "toe-ma-to" and you say "toe-mah-to" - the two versions are essentially identical in my book. EDIT: I noticed you changed arrow, which your edit summary indicated as "tightening" of the caption. You have "tightened" the caption, yet have in the process created an oddly-worded passage: "Pathological specimen from a sow; arrow indicates..." Might I suggest we just leave the caption as it was? Or if you feel it necessary to remove the arrow from parenthesis, that you make it two sentences and give "arrow" an indefinite article? Please and thank you. FoodPuma 02:07, 21 February 2009 (UTC)
 * Thanks for striking. --Una Smith (talk) 06:22, 9 March 2009 (UTC)


 * Strong Support - I have watched this article grow from this to the current version, and I think that it is deserving of the star. FoodPuma, great work on this, and I hope that you will stay with us after your class is done (even if it's just the occasional copyedit! :) — Ed 17  (Talk /  Contribs)  18:33, 20 February 2009 (UTC)
 * I'm still reserved about the lede. (see support/comments further below) It has been significantly rewritten, and it is more enlightening, but it still contains hard to follow sentences, e.g. "OCD affects the subchondral bone, which is beneath the cartilage surface of joints, but can also damage the articular cartilage, which forms the smooth ends of bones found at joints." What is the subject of the "can also damage..." clause? OCD? I suspect its the fragment(s). Strongly suggest rewording to clarify. Xasodfuih (talk) 22:41, 21 February 2009 (UTC)
 * Reply: The subject of the verb "damage" was clearly OCD (imo), however, I can see how it may confuse some people. This is the predicament with simplifying and attempting to explain each word: it ends up being harder and harder to word a sentence (or pararaph... or section) that makes it easy to understand in both syntax and diction. I don't feel as though your example sentence needs changing, and because I can read it in my mind and make sense of it I don't know how to fix it. You can always suggest how you may want the sentence to be written, or you could fix it yourself. Also, if you would be willing to list the other sentences that have issues, and what those issues are, I would be willing to resolve the problems. Thank you. FoodPuma 13:52, 22 February 2009 (UTC)

Ref comment -- Errors found with WP:REFTOOLS.
 * pmid17980849 | Multiple references are given the same name -- TRU  CO   22:02, 22 February 2009 (UTC)
 * Reply: Fixed. FoodPuma 22:22, 22 February 2009 (UTC)
 * Reference formatting is found up to speed.-- TRU  CO   02:59, 23 February 2009 (UTC)

In general it seems the article is well-written, both in terms of prose and article organization. However, and this is quite a concern, it feels like the authors should definitely make more of an effort to make the article accessible to a wider audience. Unless this is done, I'm inclined not to support it as an FA. (From own painful experiences at FAC, I know what it means to write technical articles and get them reviewed by laypeople. I hope I manage to be still constructive ;)).
 * Comments Jakob.scholbach (talk) 20:40, 26 February 2009 (UTC)
 * As a general point, I feel urged to reiterate that I sympathize with the challenges brought by such an FAC, but from own experiences I also know that "... is impossible" is often a wanting response. Also, I think it is common not to strike out reviewer's comments. Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)


 * Technical nomenclature: it surely is impossible (and would be senseless) not to use technical nomenclature, but, where possible, you should include a brief explanation of the terms. Especially in the first sections where all these words occur for the first time, it is (I think) insufficient to simply wikilink. Example: "Despite much research, the causes remains unclear but possible include repetitive trauma, ischemia, hereditary and endocrine factors, avascular necrosis, rapid growth, deficiencies and imbalances in the ratio of calcium to phosphorus, and anomalies of bone formation." I highlighted all words I think deserve a brief explanation. The article in total is not yet too long, so writing "...deprivation of blood (ischemia), hereditary and hormone-related factors, ..." etc. throughout would improve the presentation a lot.
 * Reply: Would you really like to read several paragraphs on explanations of words? This is not a dictionary, this is an encyclopedia: those reading this article should be assumed to have some degree of knowledge in the subject. I highly doubt a 6th grader will read anything more than the lede of an article whose title looks like it's in a foreign language. FoodPuma 00:04, 27 February 2009 (UTC)


 * Actually, perhaps you write a sort of introduction section which gathers the key words and gives some background? Try to introduce the players in this game ;) This would free you from giving definitions of terms throughout the text.
 * Reply:I can find no medical FA articles that use this method; please, link me should you find some. Until then I don't believe this is an appropriate method. FoodPuma 00:04, 27 February 2009 (UTC)
 * This replies to the preceding two replies. I'm not into med articles on WP, so can't find one right away that has an "Introduction" section. However, I have some experience with technical articles (math, actually), so this may perhaps be a "justification". Let me try to sketch what I'm thinking of. Definitely not a dictionary. How boring! I just think of a brief (10-15 lines, say) section which introduces en passant both the medical terms such as ischemia and a global picture of what goes on in general joints etc. Perhaps something à la (I fully acknowledge that what I write may and will be factual nonsense; also, it differs only little from certain parts of your text, this is also due to my incompetence -- you would have to fill this out with key facts that are somehow of general importance):
 * Proper functioning of bones depends on a variety of factors, ranging from external mechanical influences over a steady input of bones with blood supply to genetical predispositions. In joining two bones in a joint, cartillage (chondr..) plays an instrumental role [possibly include a general schematic picture of joints if there is one]. Osteochondritis dissecans (see etymology section below for an explanation of this term) is concerened with certain issues related to subchondral bones, bones lying directly under the cartillage. Any of the aforementioned reasons may give rise to malfunctionings of the joints: repetitive mechanical shocks (trauma), particularly in joints that experience high mechanical demands, such as the knee, may cause pieces of the bones to break off the main part. Lack of blood supply, ischemia, is equally critical, since ... Deprivation of constant blood supply may lead to death of the bones (osteonecrosis) and the bone's subsequent reabsorption. etc. etc.
 * Does that make sense? Jakob.scholbach (talk) 11:39, 28 February 2009 (UTC)


 * {| class="collapsible collapsed" style="width:100%;font-size:88%;text-align: left; border: 0px; margin-top: 0.2em;"

! style="background-color: #88aaff;" | Concerns raised by Jakob.scholbach that have since been addressed
 * The first paragraph of the lead contains a couple of terms that should be wikilinked cartilage and inflammation.
 * Reply:Will fix. FoodPuma 00:04, 27 February 2009 (UTC)
 * The first paragraph of the lead contains a couple of terms that should be wikilinked cartilage and inflammation.
 * Reply:Will fix. FoodPuma 00:04, 27 February 2009 (UTC)


 * The image in the lead is probably nice for connoisseurs, but to an outsider it conveys almost no information. I see two options: either rework the illustration so as to include some arrows or somehow highlight the areas where the reader should look, preferably compared to another XRay image of a healthy knee. The 2nd (I think better) option is to replace the XRay image by a schematical drawing (like the ones in high school books) showing the different parts of the joint and OCD etc.
 * Reply:If only you knew the difficulty of finding a schematical drawing that depicts OCD (and isn't copyrighted/will release copyright). I challenge you to find one, as I have spent countless hours searching for images. Perhaps I can add an arrow to mark the location of the defect since it is understandable that some users may not see it. FoodPuma 00:04, 27 February 2009 (UTC)
 * Yes an arrow or at least a more detailed image caption would be beneficiary. Or else you draw something? I can see that you get bothered, but I have neither medical knowledge nor the graphical abilities to do such a drawing. Also, I think for the sake of neutral reviewing, reviewers should not dive into editing too much. Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)


 * Why do you put "cartilage surface" and "bone remodeling." in quotation marks? I would not do that.
 * Reply:Quotations removed. FoodPuma 00:54, 27 February 2009 (UTC)


 * "OCD affects the subchondral bone which lies beneath the cartilage surface of joints." -- is the latter part the definition of subchondral? If so, reword. Currently it is not clear whether "which lies..." is an additional piece of information or just the definition.
 * Reply:How would you suggest I reword this? I thought it was obvious that subchondral bone is the subject of "which lies...". FoodPuma 00:54, 27 February 2009 (UTC)
 * I'm serious, but I get the impression you might want to cool down. Then you would see that "The subcortical basket which lies under an apple tree" may have two meanings: either lying under an apple tree has nothing to do with apple trees or subcortical means lying under an apple tree. In your case you mean the latter, so find a wording that does the job. E.g., just reword to "OCD affects the bone lieing beneath the cartilage surface of joints (subchondral bone)." Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)
 * Perhaps the parentheses are odd, so my 2nd try would be "OCD affects the bone lieing beneath the cartilage surface of joints, the subchondral bone." Jakob.scholbach (talk) 11:39, 28 February 2009 (UTC)


 * The previous point brings me to another problem: you should somehow explain the meaning of Osteochondritis dissecans. This is easily done in a sentence, and allows you to move on more swiftly. (E.g. the subchondral thing might be merged into a brief etymological explanation). This would also allow to smoothly circumvent semi-easter-eggs like wikilinking "osteochondral" to wikt:osteocartilage.
 * Reply:Osteochondral is used further on the article and it's wikilink is not an "easter egg" because osteo (bone) and chondral (cartilage) means the same as osteo (bone) and cartilage. Also, the meaning of Osteochondritis dissecans is made 'clear', I will reiterate: clear, in the first paragraph of the intro. It's process is described thoroughly and simply, and all technical terms are described in a way that the reader may understand. Your comment here has no backing. FoodPuma 00:54, 27 February 2009 (UTC)
 * OK, easter egg was perhaps exaggerated.


 * "which forms the smooth ends " -- are there non-smooth ends?
 * Reply:Cartilage is smooth, is it not? Does this really bother you that much? FoodPuma 00:04, 27 February 2009 (UTC)
 * Well, if you know that, it's cool. I don't and I feel many others won't either. Please don't take my comments as offenses or something; I'm just trying to point out spots which may not be understandable to many readers. Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)
 * My apologies for the first batch of replies: they were uncalled for and were an immature response to valid criticizm. This phrase has since been removed; thank you for noting, however. FoodPuma 00:18, 4 March 2009 (UTC)


 * "loss of blood flow " and later "reabsorbed" are employed twice in a row. Consider rewording. Likewise with "diseases. However, the disease"
 * Reply:I'll try to fix this, seems valid. FoodPuma 00:04, 27 February 2009 (UTC)
 * "Reabsorbed" is still used one sentence after another, but they are working in conjunction to explain the term so I think it is appropriate.


 * "are more likely to recover" - than what / who?
 * Reply:Another valid point. Will fix. FoodPuma 00:04, 27 February 2009 (UTC)


 * The paragraph about juvenile OCD is well-written. However, it looks like it gives too much emphasis to that topic. From a glance at the article (actually table of contents already suffices), this topic does not occupy a fourth of the whole article. The classification section, on the other hand, is not covered in the lead. Also the treatment section is fairly briefly done ("the problem may be treated, depending on its severity, by repairing the cartilage" only).
 * Reply:You can see the difficulty in satisfying one's request for explanation. It leads to another request and another: you and every other person requesting further simplification of the article/lede will not stop until everything is defined with it's own paragraph. I do not hold this against you, but it is more than just aggravating to be asked to explain every single term or concept with a paragraph. The reason the juvenile growth plate was explained was because it doesn't show up anywhere else in the article, and thus it needed to be explained in full. FoodPuma 00:04, 27 February 2009 (UTC)
 * Reply:Also, the lede does cover classification and the treatment section was left as is because a lede is a lede: it is not meant to describe everything in depth. Should the reader want to know more they can easily click the contents link at left. What is the point of an article if we are to explain everything in the lede?
 * I reply to both preceding replies: You may be misunderstanding my request and/or the guidelines. As I said, this paragraph is nicely written and accessible. However, the whole article has to be covered in the lead. There may be things that get a little more focus. However, by WP:LEAD "The lead should be able to stand alone as a concise overview of the article." I realize that it is difficult to be both explanatory and summarize the article, but it is feasible. I think adding a sentence about the classification and listing the main treatments is not wanting too much. Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)
 * The new lead is much better than the previous version, IMO. Perhaps a tweak here and there to replace the various occurrences of "called" in the first paragraph would be nice. Jakob.scholbach (talk) 07:51, 4 March 2009 (UTC)

FoodPuma 00:54, 27 February 2009 (UTC)
 * Many other conditions were once confused " -- "once" sounds too vague to me.
 * Reply:Do you really want me to add "in the past"? I thought "once" was pretty clear in implying the terms were confused in the past. FoodPuma 00:04, 27 February 2009 (UTC)
 * Well, its clear that it refers to the past. The question is: 1960, 1850 or 1730? Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)
 * Now it is better with the 1887 date in front of it. Jakob.scholbach (talk) 11:39, 28 February 2009 (UTC)


 * What does "These include ... accessory ossification center" mean? I have to say I even fail to parse this bit grammatically.
 * Reply:Again, in trying to satisfy others complaints I have forced myself between a rock and a hard place. I won't address this until you can come to a conclusion with Xasodfuih and Una Smith as they seem to be interested in the lede as well. FoodPuma 00:04, 27 February 2009 (UTC)
 * Regardless of what everybody wants, the lead should contain both correct and understandable English. "These include ... accessory ossification center" is not even grammatically correct, right? Does it mean centers? Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)
 * "These" was supposed to refer to "other conditions" from the previous sentence, but I (or perhaps someone else?) has corrected this and combined the sentences. Please look over if you object. FoodPuma 00:18, 4 March 2009 (UTC)


 * As far as I see all your images center around the knee. Is this to say that the knee is the most often affected joint? Jakob.scholbach (talk) 20:40, 26 February 2009 (UTC)
 * Reply:Please read the epidemiology section: you will notice that the knee does constitute 75% of cases (and is accordingly the most documented/studied site of OCD). FoodPuma 00:04, 27 February 2009 (UTC)
 * OK. Do you think this would be good to know from reading the lead? Jakob.scholbach (talk) 15:31, 27 February 2009 (UTC)
 * Now added. FoodPuma 00:18, 4 March 2009 (UTC)


 * Just a question about the term "joint mice": the source you cite does not back up your statement that it gives a squeaking sound, instead I get the impression that joint mice refers to loose parts which kind of jump around in the joint. (Also see Gelenkmaus). Is that right? Jakob.scholbach (talk) 11:39, 28 February 2009 (UTC)
 * Nice find! :-) "Joint mice" does refer to the loose parts, which in turn lead to increased crepitus. Perhaps my add of "squeaking" was a bit much eh? Will fix. FoodPuma 00:18, 4 March 2009 (UTC)


 * There are some terms also below in the text that could do with explanation and or wikilinking such as T1 (MRI) etc. Jakob.scholbach (talk) 11:56, 28 February 2009 (UTC)
 * Reply: Wikilinked T1 and T2 to the article that "kind of" explains the concept. I read into it and still don't fully understand what the two signs mean, other than that they are different frequencies at which the atom's electrons vibrate (or something to that effect) which results in different images. Nuclear physics = complicated, but the reader can find out all they really need to know from the intro (of the linked article). Also, I wikilinked them and then considered the possibilty of it being an easter egg. Thoughts? FoodPuma 00:18, 4 March 2009 (UTC)
 * I think if you link to T1 to T1 (MRI) (which currently redirects to relaxation (nmr)) this is fine. The T1 article may evolve over time, so don't worry about that too much. What I think is more important than understanding the exact physical things going on is to comment (perhaps even in the image caption) what parts are shown dark and what are shown light. Also, I'd like to reiterate my point above: you would greatly help readers (even medically trained ones, I guess) by putting an arrow to the spot you are referring to in the image caption. Jakob.scholbach (talk) 07:51, 4 March 2009 (UTC)


 * }

Update: Altogether, I think the article has substantially improved (most importantly, the new lead is now well accessible and is a good summary of the article), so I'm changing my hesitation above to support. (I hope and expect, that the image labelling suggestion still comes to reality). Jakob.scholbach (talk) 07:51, 4 March 2009 (UTC)
 * Reply: I plan on adding arrows to the two MRI scans and, perhaps more importnaly, to the main image of the infobox. I'll see if I can't address one of your above issues (sepcifically the Technical nomenclature of the body of the article). My apologies for crosing out your commernts, I was merely doing it to remind me of what issues I had fixed and what not. FoodPuma 14:04, 4 March 2009 (UTC)
 * For some reason the images on the article don't seem to "update." That is, they don't accurately represent the images at wikimedia commons (which have since been updated with arrow-edited versions). Any possible solutions? FoodPuma 03:01, 5 March 2009 (UTC)
 * No problems here, see all with arrows. Could be a browser cache issue. -- Kim van der Linde at venus 03:12, 5 March 2009 (UTC)

Image review: all images verifiably in the public domain or appropriately licensed. Jappalang (talk) 03:52, 2 March 2009 (UTC)
 * Thank you! FoodPuma 00:18, 4 March 2009 (UTC)


 * Support. The article has significantly improved (version reviewed). It is now reasonably accessible, and the lede summarizes the contents well, albeit in a little too much detail (5-paragraphs). Some of the treatment and post-operative care details could probably be omitted from the lede; having said that, I don't think those extra details there detract much, (and I know how hard it is to write both concisely and accurately on a topic like this). Xasodfuih (talk) 22:38, 4 March 2009 (UTC)
 * Xasodfuih, the lede was much improved but I still saw issues with it so I reworked it and it got a little shorter (version). Do you like it better now?  --Una Smith (talk) 07:23, 8 March 2009 (UTC)


 * Not ready: this article needs a complete MoS audit and citation cleanup.  There is no consistency on author name formatting in the citations (most medical articles use the Diberri template filler which provides consistent citation formatting, see here; there is no standard format for author names in this article).  There are WP:DASH errors, WP:MOS punctuation issues, and WP:PUNC logical punctuation errors throughouts.  I'm not sure a thorough review has been undertaken.  I recommend contacting ; he may help with a MoS tuneup and citation cleanup.  Sandy Georgia  (Talk) 04:08, 7 March 2009 (UTC)
 * Dashes and overlinking fixed; didn't find anything wrong with the captions outside of your edit.
 * (@ Puma) - What she means by authors (I think - not to put words into your mouth, Sandy), is that you have "First Last" for some, "Last, First" for some, and "Last NN" for some. Also, a few have "Last, First; First Last".
 * (@ Sandy) - not everyone, especially when he's first-timer with a medical article (:/), knows to ask someone for a MoS review beforehand... :) — Ed 17  (Talk /  Contribs)  04:49, 7 March 2009 (UTC)
 * Which is why she is pointing these things out now... Dabomb87 (talk) 04:54, 7 March 2009 (UTC)
 * (edit conflict)Reply: My apologies, SandyGeorgia, I had some MoS fixes in previous peer reviews and did not have the foresight to request an individual review. I've now posted a request on Epbr123's talk page. Thank you for suggesting fixes, and not just "failing" it right out! :-) FoodPuma 04:55, 7 March 2009 (UTC)
 * Sandy would never "fail" an FAC because of MOS issue alone. Anyway, this article looks excellent in most other respects. Dabomb87 (talk) 04:57, 7 March 2009 (UTC)
 * Unfortunately, Epbr hasn't edited in about a month, so I am not optimistic about his responding to your request. Dabomb87 (talk) 04:58, 7 March 2009 (UTC)
 * How very unfortunate that Epbr is no longer editing; he could always be counted on for MoS cleanup. No, FoodPuma, there is no chance I would archive this FAC over the remaining MoS issues, but it would be best to get them cleaned up before promotion.  Another editor who is good at this sort of work, but busy, is .  Although I'm very busy too, if it comes to that, I'll have to do the fixes myself.  Regards, Sandy Georgia  (Talk) 18:50, 7 March 2009 (UTC)
 * I'll ask for 's assistance ASAP. I'll also look into that ref link you posted - I had been using two ref/citation generators and had to fill a couple out "by hand" so I understand how their format got messed up. Cheers, FoodPuma 20:28, 7 March 2009 (UTC)
 * I forgot to mention earlier that I had been using the Diberri template filler for all of the PMID articles. There were some medical journals that didn't shop in PMID, forcing me to make their citations by hand, but for the most part I used the template filler. All book references were created by the template filler on toolserv. FoodPuma 22:28, 8 March 2009 (UTC)
 * Will give this a readthrough tonight and start some MOS cleanup. It's long; may take me a day or two. Maralia (talk) 04:20, 9 March 2009 (UTC)


 * Support, although it could do with a little massaging (it's written by a scientist, yes?). I had a go at one section, which needed a few little clean-ups. It's very good, but I can hardly bear to expose myself to the details (don't want to think about them—you must be able to switch off the blood/bones/meat aspect professionally). Tony   (talk)  10:47, 7 March 2009 (UTC) Oops, and I see that Sandy has the stomach to read more than I did, and has picked up a lot more.  Tony   (talk)  10:49, 7 March 2009 (UTC)
 * Reply: 'Tis written by a student! I feel what you just said is the biggest hurdle for this article - it's position as a fringe medical article makes even the doctors over at WP:MC WP:MED feel too uncomfortable to review (with a few exceptions on this page). I'm posting a request at the Doctor's Mess now, hopefully we can get further feedback before the time comes for Sandy's/Raul's decesion. FoodPuma 14:49, 7 March 2009 (UTC)


 * How is the article topic fringe? Because it is largely surgical, not medical in the strict sense?  Why is WP:MC involved?  Do you mean WP:MED?  WP:MED has a huge number of articles, relative to editors.  --Una Smith (talk) 05:29, 8 March 2009 (UTC)
 * Is this comment related to the featured article candidacy of this article in any way? — Ed 17  (Talk /  Contribs)  05:58, 8 March 2009 (UTC)
 * FoodPuma, do you mean there is a WP:FRINGE problem with this article? --Una Smith (talk) 06:21, 8 March 2009 (UTC)
 * My apologies for the wrong wikilink. I meant to link [[WP:MED] . First off, you and I both know it's not a fringe theory. I was trying to point out that even most doctors, unless they are involved in orthopaedics, would have little to zero understanding of this disease (beyond what the technical terms mean, eg: subchondral bone). I believe you are taking this too far, Una. Lets be realistic here and not try to bend what each other are saying. As such, I will try to be very clear with you:
 * It is "fringe" because it is not mainstream and a rather unknown topic that only orthopaedic surgeons would have any experience with.
 * I don't know what you are getting at when you say "not medical in the strict sense:" it's a known medical condition that is taught, treated and researched throughout the world (I don't think you can get much more "medical" than that).
 * Concerning it being "fringe," one might logically deduce due to the lack of research within the medical community (when compared to diseases such as tuberculosis), it's place as a relatively untreatable condition (until late) and it's epidemiology statistics as a rare disease (as well as a misdiagnosed one) that it qualifies.
 * I am going to second Ed 17  's positon - please do not try to be asinine and "shoot down" the article. Certainly, if you feel obligated to argue over the legitimacy of my claim that it's "fringe" than take it to my talk page. The FAC page is here for reviews, not criticism of my efforts to get a MoS review by a neutral editor - you are contributing nothing. Again, please don't respond on here, take it to my talk page. FoodPuma 06:33, 8 March 2009 (UTC)
 * FoodPuma, "fringe" has a specific meaning on Wikipedia. What you mean is not fringe but obscure.  Obscure topics are not a problem;  they are where Wikipedia really shines.  --Una Smith (talk) 07:11, 8 March 2009 (UTC)
 * I was going to make this remark to FoodPuma that rare diseases are not necessarily fringe science topics since they may be well researched, which is the case here. I'm collapsing this discussion because it's mostly off-topic here and getting the tint of a flame war. Xasodfuih (talk) 14:51, 8 March 2009 (UTC)

Also, I wanted to thank you for the recent edit. However I had one qualm over the substitution of "skelatally immature adolescents" with just "adolescents." For lack of better reason, I assume you were trying to simplify that sentence? It does read better in your version, but I just wanted to note that I was hoping to distinguish between skeltal maturity and immaturity (and it's relation to the growth plate). FoodPuma 06:50, 8 March 2009 (UTC)
 * FoodPuma, you are correct that the important point is epiphyseal plates open or closed. I expect the phrase "skeletally immature adolescents" came from a writer mindful of the fact that not all adolescents have open epiphyseal plates.  If adolescent alone does not work for you, how about "most adolescents"? --Una Smith (talk) 07:11, 8 March 2009 (UTC)
 * "Most adolescents" is excellent! But don't get me wrong, I would choose the most recent version (that omits the skeletally immature part) over the old version any day! Your edit is much appreciated. FoodPuma 13:49, 8 March 2009 (UTC)
 * The above discussion is preserved as an archive. Please do not modify it. No further edits should be made to this page.