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.

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

Osteochondritis dissecans most commonly affects boys between 9 and 18 years of age.

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.

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.

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.

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.

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