Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis

Osteochondritis dissecans is a term used to describe a finding on a radiograph (x-ray). It occurs most frequently in the knee joint, followed by the ankle and the elbow. The radiographic appearance is an area within the joint that is either darker or lighter than the surrounding bone. This abnormality eventually may lead to pain symptoms, but not always. It seems to occur more frequently among younger patients and is more common among men than women. The cause remains unclear, but it appears to be related to loss of blood supply in the underlying bone. This causes a small area of the bone to die, which results in a small crater near or in the joint Pain may be vague and intermittent, making the lesion difficult to diagnose. If a portion of the joint loosens, the affected joint may lock and swell. Radiographs are obtained with the patient standing. Sometimes MRI is necessary to determine the extent of the lesion.

Living With Your Diagnosis
Osteochondritis dissecans may produce only intermittent symptoms and not require any formal treatment other than observation. Minor alterations in lifestyle may eliminate additional symptoms. When pain becomes constant or if the joint actually locks and does not bend or straighten, surgical treatment may be indicated.

Pain in the knee, ankle, or elbow may occur for various reasons. The radiographic finding of an osteochondritis dissecans lesion does not necessarily explain the source of the pain, because many lesions do not become symptomatic. An evaluation is performed to determine whether the osteochondritis dissecans lesion is the true source of the pain. Rest, immobilization, and anti-inflammatory drugs can provide excellent results in most instances. No diets or exercise programs speed the healing process. Surgical treatment rarely is necessary, particularly for young patients. When the joint is protected with a cast or brace, the lesion may heal uneventfully. If, however, the pain worsens or the lesion becomes unstable, surgical treatment may provide relief. Many lesions can be managed with arthroscopic techniques, but some may require open treatment.

The DOs
•Rest and immobilize the area as needed.
•Take your medications as prescribed.

The DON’Ts
•Do not continue to participate or compete in an activity that produces symptoms consistent with osteochondritis dissecans. Doing so may harm the affected joint.

When to Call Your Doctor
•If pain becomes consistent or suddenly changes.
•If the joint locks and does not bend or straighten. Your doctor may be able to gently manipulate it or may recommend surgical treatment.