What is it?

Osteochondritis dissecans is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.
Osteochondritis dissecans occurs most often in children and adolescents. It can cause symptoms either after an injury to a joint or after several months of activity, especially high-impact activity such as jumping and running, that affects the joint. The condition occurs most commonly in the knee, but also occurs in elbows, ankles and other joints.

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Signs & symptoms

Depending on the joint that's affected, signs and symptoms of osteochondritis dissecans might include:
* Pain. This most common symptom of osteochondritis dissecans might be triggered by physical activity- walking up stairs, climbing a hill or playing sports.
* Swelling and tenderness. The skin around your joint might be swollen and tender.
* Joint popping or locking. Your joint might pop or stick in one position if a loose fragment gets caught between bones during movement.
* Joint weakness. You might feel as though your joint is "giving way" or weakening.
* Decreased range of motion. You might be unable to straighten the affected limb completely.

Diagnosis

During the physical exam, your doctor will press on the affected joint, checking for areas of swelling or tenderness. In some cases, you or your doctor will be able to feel a loose fragment inside your joint. Your doctor will also check other structures around the joint, such as the ligaments.Your doctor will also ask you to move your joint in different directions to see whether the joint can move smoothly through its normal range of motion.

Imaging tests- Your doctor might order one or more of these tests:
* X-rays. X-rays can show abnormalities in the joint's bones.
* Magnetic resonance imaging (MRI). Using radio waves and a strong magnetic field, an MRI can provide detailed images of both hard and soft tissues, including the bone and cartilage. If X-rays appear normal but you still have symptoms, your doctor might order an MRI.
* Computerized tomography (CT) scan. This technique combines X-ray images taken from different angles to produce cross-sectional images of internal structures. CT scans allow your doctor to see bone in high detail, which can help pinpoint the location of loose fragments within the joint.

Treatment

Treatment of osteochondritis dissecans is intended to restore the normal functioning of the affected joint and relieve pain, as well as reduce the risk of osteoarthritis. No single treatment works for everybody. In children whose bones are still growing, the bone defect may heal with a period of rest and protection.

Therapy
Initially, your doctor will likely recommend conservative measures, which might include:
* Resting your joint- Avoid activities that stress your joint, such as jumping and running if your knee is affected. You might need to use crutches for a time, especially if pain causes you to limp. Your doctor might also suggest wearing a splint, cast or brace to immobilize the joint for a few weeks.
* Physical therapy- Most often, this therapy includes stretching, range-of-motion exercises and strengthening exercises for the muscles that support the involved joint. Physical therapy is commonly recommended after surgery, as well.
* Surgery- If you have a loose fragment in your joint, if the affected area is still present after your bones have stopped growing, or if conservative treatments don't help after four to six months, you might need surgery. The type of surgery will depend on the size and stage of the injury and how mature your bones are.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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