What is osteochondritis dissecans?
Osteochondritis dissecans involves a loss of blood supply (or death) to part of the cartilage within the elbow joint. The exact cause of osteochondritis dissecans is not known. It may be related to repetitive trauma (multiple episodes of unrecognized injury that damage the bone and cartilage). There may also be a genetic component involved, making some people more prone to develop this condition.
Osteochondritis is most often found in adolescents ages 10-18 and is commonly associated with certain sports, including gymnastics and baseball (pitching). If the cartilage involved only partially tears off or stays in place, pain may be minimal and proper healing can progress on its own. This is more common in younger individuals. When the fragment completely tears off, it can get caught in the joint leading to pain and loss of elbow motion and function. In these cases, surgery might be necessary to relieve pain and restore use of the arm.
What are the symptoms of osteochondritis dissecans?
Some common symptoms of osteochondritis dissecans are:
- Pain, especially when fully bending or straightening the elbow
- Elbow catching and locking when bending
- A popping or cracking noise with elbow movement (crepitus)
- Swelling in the elbow
- Tenderness at the elbow when moving it
- Difficulty moving the elbow
- Reduced range of motion in the elbow
What causes osteochondritis dissecans?
Osteochondritis dissecans most often affects adolescents, especially teens who are active in high-impact sports, such as football, gymnastics, tennis, baseball and weight-lifting. As noted above, it is thought to be related to repeated impact to the elbow, which over time slows or stops the blood flow to the cartilage. Not uncommonly, an individual is not aware that any cartilage injury has taken place until pain or loss of mobility occurs.
How is osteochondritis dissecans diagnosed?
Osteochondritis dissecans is diagnosed through examination of the elbow and imaging tests. Because it is a bone condition, an X-ray or MRI is needed to evaluate the location and extent of cartilage involvement. Physicians at MOR Hand, Wrist & Elbow Institute are experts at diagnosing this condition and treat it commonly. They will develop the best treatment plan for each patient's needs. They have extensive experience with athletes who have the condition.
What are the treatments for osteochondritis dissecans?
Non-surgical Treatment Options
- Resting the elbow
- Physical therapy
- Splint or brace
- Cortisone injection
Surgical Treatment Options
Depending on the injury, the location and size of the cartilage involved, the fragment might be removed from the elbow, reattached with stitches or a screw, or treated by drilling into the bone to stimulate new cartilage growth. These surgeries can usually be done arthroscopically, in a minimally invasive way, through tiny incisions. A brace is usually worn for a few weeks after surgery to provide comfort and support and allow ample healing time. In some cases, therapy is necessary to ensure the best recovery. The physicians at the MOR Hand, Wrist & Elbow Institute have particular expertise in the evaluation and treatment of osteochondritis dissecans.
Drs. Mark Cohen, John Fernandez and Robert Wysocki are experienced physicians with the Midwest Orthopaedics at Rush (MOR) Hand, Wrist & Elbow Institute in Chicago. They perform surgery at Rush University Medical Center (Chicago) and Rush Oak Park Hospital.
For additional information about the Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute, please call 855 312 HAND (855.312.4263) or schedule an appointment.