osteochrondritis dissecans

Question 1

what is it

general affects young adults or children

Answer 1

Osteochondritis dissecans (OCD) is a pathological process affecting the subchondral bone (most often in the knee joint) with secondary effects on the joint cartilage, including pain, oedema, free bodies and mechanical dysfunctions.

Question 2

pt present with

Answer 2

Knee pain and swelling, typically after exercise

Knee catching, locking and/or giving way

Feeling a painful ‘clunk’ when flexing or extending the knee

Question 3

if a pt with osteochrondritis dissecans has clunking when flexing or extending at the knee what does this indicate

Answer 3

• indicating the involvement of the lateral femoral condyle

Question 4

when examining a pt what do you see

Answer 4

Joint effusion

Tenderness on palpation of the articular cartilage of the medial femoral condyle, when the knee is flexed

Wilson’s sign for detecting medial condyle lesion - with the knee at 90° flexion and tibia internally rotated, the gradual extension of the joint leads to pain at about 30°, external rotation of the tibia at this point relieves the pain

Question 5

what is the MX and IX

Answer 5

need XRay and potential for MRI - low threshold for ortho

Question 6

what causes it

The exact reason why blood flow may become interrupted in a segment of the bone is unknown.

Answer 6

repetitive trauma or stress on a joint
genetic predisposition in some pts