Osteochondritis Dissecans

Osteochondritis Dissecans is a fragmentation of the cartilage and sometimes the underlying bone within a joint. This is common in adolescents as the ends of the bones are not yet fully hardened.

Symptoms of Elbow Osteochondritis Dissecans

  • Locking and clicking of the elbow.
  • Swelling which comes and goes.
  • Loss of full function or movement.
  • Intermittent pain.
  • Pain after activity.

Causes

It is caused by the separation of a fragment of cartilage (usually some attached bone as well) from the joint surface. This occurs due to a disruption to the blood flow. This most commonly occurs at the capitellum (end of the humerus, or upper arm bone). This fragment is sometimes known as a loose body as it tends to float around within the elbow joint.

This condition may also be referred to as an Osteochondral Fracture. The term Osteochondritis Dissecans is actually falling out of favour because the 'itis' at the end suggests inflammation, which is now known not to be present in this injury.

Osteochondritis dissecans occurs especially in young athletes involves in throwing sports such as baseball or firld athletic events like javelin. The reason for this is the valgus force (where the lower arm is force outwards) on the elbow. Previous injury to the medial ligament of the elbow may also result in this injury as it causes an increase angle and loading of the capitellum.

Treatment

  • Initial treatment involves rest, ice, compression and elevation to ease pain and swelling.
  • If problems persist, seek medical attention.
  • An X-ray or MRI may be taken to confirm the diagnosis.
  • The need for surgery depends on the amount of displacement of the fragment and the severity of symptoms.
  • Surgery involves removing the bone fragment (known as debridement)
  • If surgery is not undertaken, treatment involves rest, range or motion exercises and avoidance of throwing activities until pain has cleared.
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