Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone separates from the end of the bone because of inadequate blood supply. The separated fragments are sometimes called “joint mice”. These fragments may be localized, or may detach and displace into the joint space causing pain and joint instability. Osteochondritis dissecans can occur in any of the joints including your elbows, ankles, shoulders and hips. Osteochondritis dissecans is more common among boys and young men between 10 and 20 years who actively take part in sports. Athletes participating in sports such as gymnastics and baseball may develop osteochondritis dissecans.
The exact cause for osteochondritis dissecans remains unknown and certain factors such as trauma, fractures, sprains, or injury to the joint are considered to increase the risk of developing the condition. Osteochondritis dissecans may be caused by restricted blood supply to the end of the affected bone that usually occurs in conjunction with repetitive trauma. Following the injury or trauma, the bones in the area may be deprived of blood flow leading to necrosis and finally the bone fragment may break off. This may initiate the healing process, however, by this time, articular cartilage will be compressed, flattened, and a subchondral cyst will be developed. All these changes in addition to increased joint pressure cause failure of healing of the joint.
Patients with osteochondritis dissecans usually have elbow joint pain, swelling, stiffness, and decreased range of motion. Pain usually increases after activity. Your physician may recommend various treatments depending on the reports of diagnostic scans, age, severity, stability of the cartilage and other factors. Goals of treatment are to relieve the symptoms and stop or impede the progression of degeneration of the joint. Conservative management may include rest, ice, activity modification, anti-inflammatory medication, physical therapy, and/or injections. Depending on the severity of the condition, surgical treatment may be warranted. Some of the surgical procedures include drilling, bone grafting, loose body removal, open reduction internal fixation, or cartilage transplantation.