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General Medicine

Osteochondritis Dissecans

Reviewed 06/2018
 


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 cartilage ...

DIAGNOSIS

HISTORY

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

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

  • Pain may be associated with clicking, swelling, lock...

TREATMENT

GENERAL MEASURES

  • Goals of treatment

    • Maintain a smooth, congruous joint surface.

    • Alleviate pain.

    • Prevent degenerative joint disease.

    • Promote revascularization of necrotic fragment and regeneration...

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
Abouassaly M, Peterson D, Salci L, et al. Surgical management of osteochondritis dissecans of the knee in the paediatric population: a systematic review addressing surgical techniques. Kne...

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.

  • Chambers HG, Shea KG, Anderson AF, et ...

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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Related Images
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FIG. 6.44. Magnetic resonance imaging appearance of avascular necrosis. A: Transverse T1-weighted image of a patient (supine) with hip pain on long-term steroid therapy for lupus erythematosus shows nonspecific marrow edema (arrow) in the left femoral head (f). The location and clinical context of this finding are suggestive of avascular necrosis, but the imaging appearance is otherwise nonspecific. a, acetabulum; b, bladder. Sagittal T1
FIG. 6.44. Magnetic resonance imaging appearance of avascular necrosis. A: Transverse T1-weighted image of a patient (supine) with hip pain...
FIG. 95.7. Radiograph of the left hip joint of a 22-year-old man with Gaucher’s disease illustrating avascular necrosis of the head of the femur. This radiograph was obtained 2 years after the onset of pain in the hip.
FIG. 95.7. Radiograph of the left hip joint of a 22-year-old man with Gaucher’s disease illustrating avascular necrosis of the head of the ...
FIG. 12.6. Osteochondritis dissecans. A: The anteroposterior view in normal. B: The tunnel view clearly shows a defect of the subchondral bone.
FIG. 12.6. Osteochondritis dissecans. A: The anteroposterior view in normal. B: The tunnel view clearly shows a defect of the subchondral b...
Fig B 14-3. Osteochondritis dissecans (arrow) at the ankle.
Fig B 14-3. Osteochondritis dissecans (arrow) at the ankle.
Fig B 24-7. Osteochondritis dissecans. (A) Knee. (B) Ankle.
Fig B 24-7. Osteochondritis dissecans. (A) Knee. (B) Ankle.
FIG. 6.44. Magnetic resonance imaging appearance of avascular necrosis. A: Transverse T1-weighted image of a patient (supine) with hip pain on long-term steroid therapy for lupus erythematosus shows nonspecific marrow edema (arrow) in the left femoral head (f). The location and clinical context of this finding are suggestive of avascular necrosis, but the imaging appearance is otherwise nonspecific. a, acetabulum; b, bladder. Sagittal T1
FIG. 6.44. Magnetic resonance imaging appearance of avascular necrosis. A: Transverse T1-weighted image of a patient (supine) with hip pain...
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