Osteochondritis dissecans

Diagnosis

During the physical examination, your doctor will press on the injured joint to feel for any soreness or swelling. You or your doctor might occasionally be able to feel a loose piece inside your joint. In addition, your doctor will examine the ligaments and other structures close to the joint.

In order to determine whether the joint can move easily across its usual range of motion, your doctor may also ask you to move the affected joint in various directions.

Imaging tests

One or more of these tests may be prescribed by your doctor:

• X-rays. Joint’s bone anomalies might be seen on X-rays.
• Magnetic Resonance Imaging (MRI). An MRI may provide precise images of both hard and soft tissues, including the bone and cartilage, by using radio waves and a strong magnetic field. Your doctor may recommend an MRI if your X-rays come back clear but you are still experiencing symptoms.
• Computerized Tomography (CT) scan. With this method, cross-sectional pictures of interior structures are created by combining X-ray images taken at various angles. With the use of a CT scan, your doctor can identify the precise location of any loose bone fragments within the joint by viewing the bone in great detail.

Treatment

In addition to reducing the risk of osteoarthritis, treatment for osteochondritis dissecans aims to relieve pain and return the damaged joint to its normal state of function. There is no specific treatment, which is effective for everyone. When children’s bones are still developing, a time of rest and protection may help the bone deformity mend.

Therapy

Your doctor will likely first advise taking conservative action, which could entail:

• Resting your joint. If your knee is hurting, stay away from sports like jumping and running. If discomfort makes you limp, you might need to use crutches for a while. Additionally, your doctor could advise immobilizing the joint for a few weeks by wearing a brace, cast, or splint.
• Physical therapy. Stretching, exercises to increase range of motion, and activities to strengthen the muscles that support the affected joint are the most frequent components of this therapy. Following surgery, it is advised to continue with physical therapy.

Surgery

You may require surgery if you have a loose fragment in your joint, if the damaged area persists after your bones have ceased developing, or if conservative therapy is ineffective after four to six months. The size and stage of the injury and the maturity of your bones will determine the type of surgery.