Osteochondritis Dissecans

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

Osteochondritis dissecans facts

  • Osteochondritis dissecans is a joint condition whereby a variable amount of bone and its adjacent cartilage loses its blood supply.
  • Osteochondritis dissecans causes irregularity and fragility of affected cartilage. As a result, it is possible for portions of cartilage to become lodged within the joint, leading to limitation in motion.
  • The cause of osteochondritis dissecans is often unknown.
  • Symptoms include joint pain, stiffness, and even locking of the joint.
  • Osteochondritis dissecans is best diagnosed with imaging studies.
  • Arthroscopic surgery is a procedure that is frequently used as a treatment to remove the loose cartilage and bone tissue from the joint.

What is osteochondritis dissecans?

Osteochondritis dissecans is a joint condition whereby a variable amount of bone and its adjacent cartilage loses its blood supply. Osteochondritis dissecans can involve the bone and cartilage of virtually any joint. Elbows and knees are most commonly affected. Usually, only a small portion of the affected cartilage is involved. Osteochondritis dissecans most commonly affects boys between 9 and 18 years of age.

What causes osteochondritis dissecans?

The cause of osteochondritis dissecans is often unknown. Theories include mild recurrent injuries or growth disturbances.

What are symptoms of osteochondritis dissecans?

Symptoms of osteochondritis dissecans are a direct result of the irregularity of the cartilage within the affected joint. Symptoms include joint pain, stiffness, and even locking of the joint so that its range of motion is significantly limited to the point that it cannot be moved beyond a limited range. For example, when osteochondritis dissecans affects the elbow, the joint may not move beyond 90 degrees of extension instead of being able to fully extend straight to 180 degrees.

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Osteochondritis Dissecans

Joint Pain

Joint pain can be caused by injury affecting any of the ligaments, bursae, or tendons surrounding the joint. Injury can also affect the ligaments, cartilage, and bones within the joint. Pain is also a feature of joint inflammation (arthritis, such as rheumatoid arthritis and osteoarthritis) and infection, and extremely rarely it can be a cause of cancer of the joint. Pain within the joint is a common cause of shoulder pain, ankle pain, and knee pain. Joint pain is also referred to as arthralgia.

How do health care professionals diagnose osteochondritis dissecans?

Osteochondritis dissecans can be suggested clinically by observing the lack of full range of motion with "locking" of the joint at a certain angle. It is at this angle that the loosened cartilage and bone is literally being "pinched" as the joint is attempting to move. Ultimately, osteochondritis dissecans is best diagnosed with imaging studies, such as magnetic resonance imaging scan (MRI scan) or an arthrogram.

What is the treatment of osteochondritis dissecans?

There is no cure as such, but the condition can be treated by a variety of means depending on the size and location of the lesion as well as the age of the patient and the degree of symptoms. Arthroscopic surgery is a procedure that is frequently used as a treatment to remove the loose cartilage and bone tissue from the joint. It can also be used to encourage healing by drilling and fixation of lesions that are only partially detached.

Sometimes, especially in the very young (juvenile) form, osteochondritis dissecans can spontaneously correct itself.

What is the prognosis of osteochondritis dissecans?

Indicators of a worse prognosis or outcome include a large-sized lesion, a lesion on a weight-bearing area, and older age of the patient.

Is it possible to prevent osteochondritis dissecans?

It is only possible to prevent osteochondritis dissecans by preventing trauma or injury to the affected joint.

Medically Reviewed on 8/15/2018
References
REFERENCE:

Humes, H. David, et al., eds. Kelley's Textbook of Internal Medicine. 4th Edition. Philadelphia: Lippincott Williams & Wilkins, 2000.
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