UMEM Educational Pearls

Category: Orthopedics

Title: Osteochondritis Dissecans

Keywords: Knee pain (PubMed Search)

Posted: 10/14/2017 by Brian Corwell, MD (Updated: 6/13/2024)
Click here to contact Brian Corwell, MD

Complete or incomplete separation of the articular cartilage and subchondral bone

               -70% occur at the lateral aspect of the medial femoral condyle

               -Also seen in the talar dome and capitellum

Repetitive overloading leads to fragmentation and separation from surrounding bone

Prognosis better in kids than in adults

http://www.eorif.com/KneeLeg/Images/OCD4w.jpg

CC: Vague difficult to localize activity related pain and swelling. Mechanical symptoms only if loose body is present

PE: Wilson’s test

Internal tibial rotation and knee extension impinges the tibia on the OCD lesion causing pain. Pain abates with external rotation and flexion.

https://www.youtube.com/watch?v=e7zrKo41Pos

Plan of care: Limit activity and trial period of non-weight bearing for 6 weeks.

50% resolve in 10 to 18 months with conservative care.

Detached, loose or unstable fragments or failure of non-operative care will need surgery