Osteochondritis Dissecans
| Osteochondritis Dissecans |
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Osteochondritis dissecans (OCD) is where a portion of subchondral bone and articular cartilage undergoes separation from the underlying bone. This leaves a bone fragment that can be stable or unstable. It can lead to premature Osteoarthritis
Epidemiology
OCD is a rare cause of joint pain. In adults, men are more commonly affected than women, and the ankle is most commonly affected. In children OCD most commonly affects the knee, followed by the elbow and ankle.
Clinical Features
Pain is felt in the knee, elbow, or ankle either following a specific injury or following repetitive injury. Patients report that pain is worse with exercise. In more severe disease, especially in the presence of a loose body, there may be mechanical symptoms such as catching or locking. The pain may gradually get worse over several months. In OCD of the talus there may be ongoing pain after an ankle inversion injury.
On examination there is tenderness over the relevant location - medial femoral condyle, anterolateral elbow, medial or lateral talar dome
Investigations
Plain films will usually show evidence of OCD. The typical findings are a subchondral bony fragment that is surrounded by an area of crescent-shaped radiolucency. If plain films are normal and suspicion remains then MRI may be indicated. MRI can also help to grade the lesion and help with management planning.
References
Literature Review
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,
