Osteochondritis Dissecans | Testing and Diagnosis

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How is osteochondritis dissecans diagnosed?

To diagnose osteochondritis dissecans, a orthopedic specialist will take a medical history and perform a physical exam on your child. The doctor will check for pain along the affected joint line.

For osteochondritis dissecans of the knee, the doctor will conduct what’s called the Wilson Test, in which your child’s knee is bent at a 90-degree angle, then turned inward so that the shinbone rotates toward the opposite leg. Your child will extend the affected leg to the point of pain. If your child has osteochondritis dissecans, he or she will reach that point at about 30 degrees of flexion. If rotating your child’s foot back into its normal position facing forward alleviates the pain, then he or she has osteochondritis dissecans.

To diagnose osteochondritis dissecans of the elbow, ankle or another joint, your child’s doctor will perform similar specialized manipulations.

What are the tests for osteochondritis dissecans?

Various tests may be used to confirm the osteochondritis dissecans diagnosis.

  • X-rays: Typically, multiple x-ray views are taken to confirm and assess the extent of the injury. X-rays may also be taken of the same joint on the other limb as a basis for comparison.
  • MRI (magnetic resonance imaging): An MRI can show whether the loose piece is still in place or has moved into the joint space.
  • Arthroscopy: Rarely needed to help assess osteochondritis dissecans, arthroscopy is a minimally-invasive outpatient procedure that inserts a small camera into the joint for the doctor to inspect.

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