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Detailed information of OSTEOCHONDRITIS DISSECANS
OSTEOCHONDRITIS DISSECANS
DEFINITION:
An osteochondritis involving the medial femoral condyle resulting
in knee pain and swelling.
EPIDEMIOLOGY:
- incidence: ?
- age of onset:
- two groups: less than 12 years of age & young adults
- risk factors:
- may be familial, usually sporadic
- M > F (3:1)
PATHOGENESIS:
- repeated trauma to a segment of bone with poor vascularity
results in subchondral bony necrosis under the articular
cartilage
- usually unilateral (90% of cases)
- complications: may get partial or complete separation of the
avascular bone from the cartilage
CLINICAL FEATURES:
- recurrent and diffuse with aching after exercise
- with deep palpation to the lateral aspect of the medial
femoral condyle
- inhibits full flexion of knee
- stiff, clicking with occasional locking of knee -> limp
- may be associated with muscle atrophy & mild joint
swelling
- may also occur in the patella and lateral condyle
- may also involve multiple joints: hip, knee, ankle, elbow,
and shoulder
INVESTIGATIONS:
- radiolucent fragment of subchondral bone at femoral
condyle
- separation of bone from cartilage
- may be confirmed by CT or MRI
MANAGEMENT:
- if growth plates open
- rest (+/- long-leg cast), isometric quadriceps exercises
2. Surgical
- open arthrotomy or arthroscopic correction, i.e., pinning
- for large lesions (> 1 cm), history of joint locking,
symptoms greater than 6 months
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Pediatric Database - OSTEOCHONDRITIS DISSECANS
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