What’s osteochondritis dissecans?

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Osteochondritis dissecans is a condition that affects the joints, most commonly the knee, and is caused by injury or overuse. Symptoms include pain, swelling, and decreased range of motion. Treatment includes rest, medication, physical therapy, and sometimes surgery. Early diagnosis is important to prevent long-term disability.

Osteochondritis dissecans is a condition in which the blood supply is cut off at the end of a bone, resulting in the fragmentation of bone and cartilage in the joint. Most commonly, the knee is affected, but osteochondritis dissecans can also occur in the elbow, ankle, or hip. Typically, the patient with osteochondritis dissecans is an older child or teenager. Young adults who actively participate in sports are also at risk for this condition. If early diagnosis and treatment are not sought, permanent and long-term disability can result.

Generally, symptoms of osteochondritis dissecans can include pain and blockage in the affected joint. Additionally, joint swelling and tenderness, as well as decreased range of motion, may be present. Sometimes, if the condition affects the knee, lameness and failure of the joint may be noted. Most often, however, pain is present during physical activity, especially when climbing stairs or walking on an incline.

Typically, causes of osteochondritis dissecans include injury or trauma to the joint or overuse. Usually, when the blood supply is compromised, it is often because small vessels are blocked and this can, over time, cause bone necrosis or death. Genetic predisposition may also play a role in osteochondritis dissecans.

There are some risk factors that can contribute to the development of osteochondritis dissecans. These risk factors can include repetitive movements that cause substantial impact on the joints, such as jumping; these movements place stress on the joints, which can lead to decreased blood supply to the bone. Other risk factors may include being young and playing sports, such as gymnastics, tennis and basketball. Sports that involve pivoting and jumping also often contribute to this condition.

Osteochondritis is increasingly common in women. The reason for this phenomenon is that they participate more frequently in organized sports. Young adults are encouraged to see a doctor if they experience persistent pain in a joint. In general, any joint swelling or inability to fully extend the leg or arm should receive prompt medical evaluation.

Diagnosing this condition usually requires your doctor to take a detailed medical and social history. Important information such as sports and exercise history should also be provided to the doctor. Other diagnostic tools may include joint x-rays and CT scans. Sometimes, magnetic resonance imaging (MRI) and bone scans can be used to determine bone and joint abnormalities.
Treatments for osteochondritis dissecans generally include resting the joint and anti-inflammatory medications. Joint immobilization with a splint and physical therapy are often included in the plan of care to restore mobility and strengthen surrounding muscles. Sometimes, when the patient does not respond favorably to nonsurgical treatment methods, surgical procedures, such as arthroscopy, can be used to treat the condition.




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