Description

Osteochondritis dissecans (I-t-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. This bone and the cartilage, then, you can break down, causing pain and, possibly, to hinder the movement of the joint.

Osteochondritis dissecans occurs more frequently in children and adolescents. It can cause symptoms after an injury to a joint or after several months of activity, especially of high-impact activity, such as jumping and running, that affects the joint. The condition occurs most often in the knee, but also occurs on the elbows, ankles and other joints.

The doctors of the stage osteochondritis dissecans in accordance with the size of the lesion, if the fragment is, in whole or in part, and if the fragment is kept in its place. If the loosened a piece of cartilage and bone remains in place, you may have few or no symptoms. Young children whose bones are still in development, the injuries may heal by itself.

Surgery may be required if the fragment breaks off and is caught between the moving parts of the joint, or if you have persistent pain.

Symptoms

Depending on the joint affected, the signs and symptoms of osteochondritis dissecans may include:

  • Pain. This most common symptom of osteochondritis dissecans might be caused by the physical activity — walking up the stairs, going up a hill or playing sports.
  • Swelling and sensitivity. The skin around the joint may be swollen and tender.
  • Joint popping or locking. Your set may or pop a stick in one position if a fragment loose is trapped between the bones during movement.
  • Joint weakness. You may feel as if their joint "give way" or weakening.
  • Decreased range of motion. You may be unable to straighten the affected member completely.

When to see a doctor

If you have persistent pain, or pain in your knee, elbow or other joint, see your doctor. Other signs and symptoms that should prompt a call or visit to your doctor include swelling of the joints or an inability to move a joint through its full range of motion.

Causes

The cause of osteochondritis dissecans is unknown. The reduction of blood flow to the end of the affected bone may result from repetitive trauma — small, multiple episodes of minor, non-recognized lesion that damage the bone. There may be a genetic component, making some people more likely to develop the disorder.

Risk factors

Osteochondritis dissecans occurs more frequently in children and adolescents between the ages of 10 and 20 years, which are very active in sports.

Complications

Osteochondritis dissecans may increase your risk of eventually developing osteoarthritis in the joint.

Prevention

The adolescents participating in organized sports may benefit from education about the risk to their joints associated with excessive use. Learning the proper mechanics and techniques of their sport, using the appropriate protective equipment, and participate in the training of the force and the stability of the training exercises can help to reduce the chance of injury.

Diagnosis

During the physical exam, your doctor will put pressure on the affected joint, checking for areas of swelling or tenderness. In some cases, you or your doctor will be able to feel a piece loose on the inside of the joint. The doctor will also check other structures around the joint, such as ligaments.

In addition, your doctor will ask you to move your joint in different directions to see if the joint can be easily move through its normal range of motion.

Imaging tests

Your doctor may order one or more of the following tests:

  • The x-ray. X-ray can show abnormalities in the articulation of the bones.
  • Magnetic resonance imaging (MRI). The use of radio waves and a strong magnetic field, a magnetic resonance imaging can provide detailed images of the soft and hard tissues, such as bone and cartilage. If the X-rays appear normal, but you still have symptoms, your doctor may order a magnetic resonance imaging.
  • Computed tomography (CT scan). This technique combines X-ray images taken from different angles to produce cross-sectional images of the internal structures. The CT scan allows your doctor to see the bone at a high level of detail, which can help to identify the location of the loose fragments within the joint.

Treatment

The treatment of osteochondritis dissecans is intended to restore the normal functioning of the affected joint and relieve pain, as well as reduce the risk of osteoarthritis. There is not a treatment that works for everyone. In children, whose bones are still growing, the bone defect can be cured with a period of rest and protection.

Therapy

Initially, your doctor will probably recommend conservative measures, which could include:

  • Resting the joint. Avoid activities that stress on the joints, such as jumping and running, if your knee is affected. You may need to use crutches for a while, especially if the pain makes you weak. Your doctor may also suggest the use of a splint, cast or a splint to immobilize the joint for a couple of weeks.
  • The physical therapy. Most often, this therapy includes stretching range-of-motion exercises and strengthening exercises for the muscles that support the affected joint. Physical therapy is commonly recommended after surgery, as well.

Surgery

If you have a fragment loose in your set, if the affected area is still present after their bones have stopped growing, or if the conservative treatments do not help after four to six months, you may need surgery. The type of surgery will depend on the size and stage of the lesion and the maturity of their bones.

Preparing for your appointment

You might first consult with their family doctor, who might refer you to a doctor who specializes in sports medicine or orthopedic surgery.

What you can do

  • Write down your symptoms and when they began.
  • The list of medical information, including other conditions you have and the names of the medications, vitamins, or supplements you take.
  • Note recent accidents or injuries that could have damaged the back.
  • Have a family member or friend along, if possible. Someone who accompanies you can help remember what your doctor tells you to.
  • Write questions to ask your doctor to make the most of your appointment time.

For osteochondritis dissecans, some basic questions to ask your doctor include:

  • What is the most likely cause of my pain in the joints?
  • There are other possible causes?
  • I need diagnostic tests?
  • What treatment do you recommend it?
  • If you are recommending medications, what are the possible side effects?
  • How long should I take the medicine?
  • Am I a candidate for surgery? Why or why not?
  • There are restrictions that must be followed?
  • What self-care measures should I take?
  • What can I do to prevent my symptoms from recurring?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • When did your symptoms begin?
  • Inflamed joints? Make block or give out on you?
  • Does anything make your symptoms better or worse?
  • How limiting is your pain?
  • You have wounds that joint? If so, when?
  • Do you practice any sport? If so, what?
  • What treatments or self-care measures have you tried? Nothing has helped?
Symptoms and treatment of Osteochondritis dissecans