Osteochondritis dissecans (OCD) is a joint condition whereby a segment of bone and its adjacent cartilage loses its blood supply and begins to separate from the surrounding tissue. This process can lead to pain and joint dysfunction, particularly if the loose fragment starts to move within the joint space. OCD most commonly affects the knees, but it can also occur in other joints such as the elbows, ankles, and hips.

Symptoms

The symptoms of osteochondritis dissecans can vary depending on the severity and the joint involved but often include:

• Joint pain and tenderness, especially after periods of rest or upon waking

• Swelling and warmth in the affected joint

• Stiffness or decreased range of motion

• A feeling that the joint is "catching" or "locking" during movement

• In severe cases, fragments of the bone and cartilage can break loose, leading to a sensation of the joint giving way

Causes

The exact cause of osteochondritis dissecans remains unclear, but it is believed to result from a combination of genetic, environmental, and mechanical factors. Reduced blood flow to the end of the affected bone is thought to be a significant contributor. Repetitive trauma or stress on a joint, common in athletes, may also play a role in the development of OCD.

Diagnosis

Diagnosis of osteochondritis dissecans typically involves a physical examination and imaging tests. X-rays can show abnormalities in the bone, while magnetic resonance imaging (MRI) provides detailed images of both the bone and the soft tissues, including the cartilage. These imaging tests help determine the size and location of the lesion and whether any loose fragments are present.

Treatment

Treatment for osteochondritis dissecans depends on the age of the patient, the stage of the condition, and the specific joint involved. Options include:

• Non-surgical treatment: In cases where the lesion is stable (not likely to detach), treatment may involve rest, the limitation of physical activities, and physical therapy to strengthen the muscles around the joint and improve its function. Bracing or casting may be used to protect the joint and allow the lesion to heal.

• Surgical treatment: Surgery may be required if the lesion is unstable, if there are loose fragments, or if non-surgical treatment fails to relieve symptoms. Surgical options can include arthroscopic procedures to remove loose fragments, drilling to promote new blood vessel growth and healing, or grafting to replace damaged bone and cartilage.

The prognosis for individuals with osteochondritis dissecans varies, with younger patients who have not yet reached skeletal maturity often having a better outlook. Early diagnosis and appropriate treatment are crucial to prevent further joint damage and to maintain joint function.