Osteochondritis Dissecans - Carrollton, TX
OCD or Osteochondritis Dissecans is a medical condition that sets in children or adolescents (10-20 years old) when a part of their bone begins to die and disintegrate from the surrounding structures due to loss of blood supply. This results in cracking and damage of the bone and cartilage within the affected part of the body. OCD may affect any joint in the body though it is the elbow, knee and ankle that are most commonly inflicted. A child may develop OCD in one or multiple joints at the same time. Osteochondritis Dissecans may result in development of osteoarthritis in the affected joint.

Causes

  • Indulging in high impact sport activities that involve a lot of jumping and running
  • External injury caused to the joint
  • Multiple minor injuries that may go unnoticed but result in damage to the blood vessels within the joint
  • Some people are genetically prone to developing such a problem

Symptoms

  • Pain in the affected joint
  • Swelling and tenderness in the affected part
  • Limited range of motion
  • Playing a sport or strenuous activities may aggravate the symptoms
  • Catching or locking of the joint may occur
  • Weakness is felt in the legs, feet or arms depending on the joint that is affected

Diagnosis

  • The patient’s medical history, prevalent symptoms and daily activities are discussed
  • The doctor may palpate to feel the joint, detect loose bone fragments and damage to the ligaments
  • X-ray imaging is essential to study the bone structure and identify the exact location of the OCD lesion
  • MRI scans or ultrasound tests may be conducted for analysis of the soft tissues and severity of damage to the cartilage

Treatment

  • In case of young children who are still in their growth stage, the bone and articular cartilage may heal with time but in others, medical treatment or surgery may be required.
  • The patient is advised rest and to abstain from sports or stress causing activities. This generally helps the child recover within a few weeks (6-8)and he/she will be able to resume daily activities normally
  • The affected joint may be immobilized using a cast or a splint
  • Crutches may be used to prevent weight bearing in case OCD is in the knee or ankle joint
  • Pain relief and anti inflammatory medicines may help cope with the symptoms

Surgery may be required if a part of the bone breaks loose and begin floating in the joint spaces or if the problem persists after trying the conservative methods. Surgery is also conducted if the OCD lesion is larger than 1 centimeter. The processes may include the following

  • Fixing the lesion using pins and screws
  • Bone graft- the damaged bone and cartilage is removed and a new piece is taken from another joint to replace it. This new piece of bone then grows naturally within the joint
  • The lesion may be punctured by drilling into it with the aim of promoting blood supply to the damaged bone
  • Physical therapy is required for a few weeks post surgery to regain movement and strength