Osteochondritis Dissecans

What is osteochondritis dissecans?

Osteochondritis dissecans (OCD) is a joint disorder in which a segment of bone and cartilage starts to separate from the rest of the bone after repeated stress or trauma. The fragment may stay in place or fall into the joint space. This causes pain and a sense that the joint is “catching” or “giving way.” These loose pieces are sometimes called “joint mice” or “loose bodies.”

Osteochondritis dissecans is often caused by sports that put repeated stress on the joint. Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. Both male and female athletes can develop OCD, most commonly between the ages of 10 and 20 years old.

  • Osteochondritis dissecans of the knee is often the result of sports that involve high-impact landings, such as football, soccer, and gymnastics.
  • Osteochondritis dissecans of the elbow can result from sports with repeated overhead throwing, such as baseball, and repetitive weightbearing on the arms, such as gymnastics.
With osteochondritis dissecans of the elbow, a segment of bone in the elbow joint separates from the rest of the bone.
With osteochondritis dissecans of the knee, a segment of bone in the knee joint separates from the rest of the bone.

Children with osteochondritis dissecans should receive medical treatment right away. Without treatment, a loosened fragment of bone and cartilage may drift into the joint, causing it to slip, pop or lock. If this happens, the joint can get “stuck,” until it’s moved manually or otherwise manipulated.

What are the symptoms of osteochondritis dissecans?

The first sign of an osteochondritis dissecans injury may be a “popping” sensation in the injured joint. Most people can still use the injured joint, and unfortunately many athletes keep playing, which often makes the injury worse.

When symptoms of inflammation set in, the affected joint feels painful and tight. Your child may also have:

  • soreness or tenderness at the joint
  • swelling or stiffness around the joint
  • difficulty fully straightening the arm or leg
  • feeling like the joint is locking, “catching,” or “giving way”
  • collection of fluid around the joint (“water on the knee”)

The signs and symptoms of osteochondritis dissecans can resemble those of other overuse injuries. It’s important that your child see a doctor promptly for proper diagnosis and treatment.

What causes osteochondritis dissecans?

Young athletes involved in high-impact sports can sustain an osteochondritis dissecans injury from motions that put repetitive stress on the joint.

Meet Ryker

The football kicker’s dreams of playing for a Division 1 college team were nearly cut short by osteochondritis dissecans. After surgery, he came back stronger than ever.

 

Learn more about Ryker

How we care for osteochondritis dissecans

The Boston Children’s Hospital Orthopedics and Sports Medicine Center provides comprehensive assessment, treatment, and follow-up care to children, adolescents, and young adults with osteochondritis dissecans. We understand the importance of sport in young athlete’s lives and are dedicated to providing the best care possible to help our patients return to their sports safely, without risking further injury.

Members of our orthopedics and sports medicine team travel to local and regional schools, youth groups and sports clubs to teach leg strengthening and other techniques with a goal of dramatically reducing overuse injuries like osteochondritis dissecans. We also conduct safe-training programs and clinics for coaches.

Patient resources

Osteochondritis dissecans of the elbow

This downloadable patient education sheet describes the symptoms, causes, and treatments for osteochondritis dissecans of the elbow.