Dr. M.J. Bazos, MD.
Patient Handout
OSTEOCHONDRITIS
DISSECANS
About Your
Diagnosis
Osteochondritis dissecans is a term used
to describe a finding on a radiograph (x-ray). It occurs most frequently in the
knee joint, followed by the ankle and the elbow. The radiographic appearance is
an area within the joint that is either darker or lighter than the surrounding
bone. This abnormality eventually may lead to pain symptoms, but not always. It
seems to occur more frequently among younger patients and is more common among
men than women. The cause remains unclear, but it appears to be related to loss
of blood supply in the underlying bone. This causes a small area of the bone to
die, which results in a small crater near or in the joint Pain may be vague and
intermittent, making the lesion difficult to diagnose. If a portion of the joint
loosens, the affected joint may lock and swell. Radiographs are obtained with
the patient standing. Sometimes MRI is necessary to determine the extent of the
lesion.
Living With Your
Diagnosis
Osteochondritis dissecans may
produce only intermittent symptoms and not require any formal treatment other
than observation. Minor alterations in lifestyle may eliminate additional
symptoms. When pain becomes constant or if the joint actually locks and does not
bend or straighten, surgical treatment may be
indicated.
Treatment
Pain
in the knee, ankle, or elbow may occur for various reasons. The radiographic
finding of an osteochondritis dissecans lesion does not necessarily explain the
source of the pain, because many lesions do not become symptomatic. An
evaluation is performed to determine whether the osteochondritis dissecans
lesion is the true source of the pain. Rest, immobilization, and
anti-inflammatory drugs can provide excellent results in most instances. No
diets or exercise programs speed the healing process. Surgical treatment rarely
is necessary, particularly for young patients. When the joint is protected with
a cast or brace, the lesion may heal uneventfully. If, however, the pain worsens
or the lesion becomes unstable, surgical treatment may provide relief. Many
lesions can be managed with arthroscopic techniques, but some may require open
treatment.
The
DOs
•Rest and immobilize the area
as needed.
•Take your medications as
prescribed.
The
DON’Ts
•Do not continue to
participate or compete in an activity that produces symptoms consistent with
osteochondritis dissecans. Doing so may harm the affected
joint.
When to Call Your
Doctor
•If pain becomes
consistent or suddenly changes.
•If
the joint locks and does not bend or straighten. Your doctor may be able to
gently manipulate it or may recommend surgical treatment.