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Osteochondritis Dissecans

J David Honeycutt, MD and Catherine E LaRowe, D.O. Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Osteochondritis dissecans (OCD) is a lesion of subchondral bone that may cause separation from, and instability of, overlying articular cartilage.

  • The loose piece of bone and cartilag...

DIAGNOSIS

HISTORY

  • Insidious (most common) or posttraumatic onset of pain, which improves with rest

  • Pain is usually described as a deep and vague ache that is poorly localized.

  • Pain may be associated with...

TREATMENT

GENERAL MEASURES

  • Treatment is based on skeletal maturity and lesion stability (1)[A],(2)[A]. 

  • AOCD rarely heals without surgical interventions (3)[A].

  • Goals of treatment

    • Maintain a smooth, con...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Outpatient care is the usual course.

  • Inpatient treatment for surgical intervention

Patient Monitoring

  • 6-week intervals are appropriate to assess for fragment displac...

REFERENCES

1
Chau MM, Klimstra MA, Wise KL, et al. Osteochondritis dissecans: current understanding of Epidemiology, etiology, management, and outcomes. J Bone Joint Surg AM. 2021;103(12):1132–1151.
2
Mc...

ADDITIONAL READING

  • Bauer  KL, Polousky  JD. Management of osteochondritis dissecans lesions of the knee, elbow and ankle. Clin Sports Med.  2017;36(3):469–487. [View Ab...

CODES

ICD10

  • M93.20 Osteochondritis dissecans of unspecified site

  • M93.269 Osteochondritis dissecans, unspecified knee

  • M93.229 Osteochondritis dissecans, unspecified elbow

  • M93.279 Osteochondritis dissecans,...

CLINICAL PEARLS

  • OCD is an acquired lesion of the subchondral bone, causing separation of the overlying articular cartilage; it may become unstable and require surgical intervention; the knee is the mo...

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