What is Osteochondritis Dissecans?

Osteochondritis dissecans (OCD) is a condition in which a piece of bone loses blood supply and begins to separate from the surrounding bone. That piece, along with its overlying cartilage, can become loose.

Although the condition can occur in any joint, OCD commonly occurs in the knee, elbow and ankle. OCD is more common in children, teens and young adults (10 to 20 years old), but it can occur in people of all ages. It affects more males than females, and tends to run in families.

What Causes Osteochondritis Dissecans?

In many cases, the cause of osteochondritis dissecans isn’t clear. However, some experts believe the condition is caused by an injury that involves twisting or bending, or by repetitive stress to the joint.

Osteochondritis Dissecans Symptoms and Effects

The most common symptoms of OCD include:

  • Pain in a joint, which typically worsens with activity.
  • Swelling of a joint, which typically worsens with activity.
  • Joint weakness or stiffness.
  • Joints that catch or lock.
  • Decreased range of motion.
  • A sensation that something is moving inside the affected joint.

Osteochondritis Dissecans Diagnosis and Treatment

If you think your child might have OCD, specialists typically start by reviewing your child’s medical history and test results and performing a physical examination.

Tests used to diagnose OCD might include:

  • X-rays: X-rays help with the initial diagnosis. They can show the location and size of the affected piece of bone and cartilage.
  • MRI: MRIs provide detailed images of the joint and its soft tissues, including cartilage.

The goals of OCD treatment are to:

  • Restore joint function.
  • Relieve pain.
  • Reduce risk of developing osteoarthritis in the affected joint.

Depending on your child’s age and the seriousness of the condition, specialists at Gillette Children’s Specialty Healthcare might recommend a combination of the following treatments.

Rest

OCD can get worse with repetitive movements and high-impact activities. Specialists might recommend avoiding activities that cause additional stress to the joint. In some cases, we recommend using crutches to reduce stress on the joint.

Anti-Inflammatory Medicines

If pain becomes a problem, we might prescribe anti-inflammatory medicines.

Physical Therapy

We might recommend physical therapy to help your child strengthen muscles and maintain range of motion.

 

Bracing

In some cases, we might recommend braces to hold the joint in position, decreasing stress on the affected joint.

Surgery

In severe cases—such as when intense pain continues even after nonsurgical treatments—we might perform surgery. Surgery might also be necessary if the loose bone fragment is very large, particularly in older teenagers.

Depending on the severity of OCD, there are several surgical procedures your child might have to treat the condition. We might decide to:

  • Drill into the affected joint to increase blood supply to the affected area and encourage healing.
  • Insert pins or screws to the joint to hold the affected segment or fragment in place.
  • Replace damaged bone or cartilage using a bone graft to help grow healthy bone and cartilage.

Integrated Care

If your child has osteochondritis dissecans, our experts will work closely with you to customize a treatment plan that fits your child’s unique needs. As we treat your child, we also pay careful attention to the areas of growing tissue near the ends of long bones (growth plates).

Your child may receive care from international experts at Gillette in a variety of fields, including:

Your family can count on our team of specialists to treat complex conditions related to OCD. We welcome the involvement of primary care providers, teachers, and school and community therapists.