Osteochondritis dissecans of elbow

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Osteochondritis dissecans of elbow:

  • An osteochondral lesion is a form of avascular necrosis involving a focal area of cartilage
  • Due to repetitive microtrauma casuing vascular insufficiency.
  • Capitulum is the third most common site (after medial femoral condyle and talar dome).
  • Most commonly affects male adolescents and young adults.
  • Radiographic feature
    – Lucent lesion at articular surface (detached osteochondral fragment), loose bodies maybe seen
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    Lucent area with sclerotic margin in capitellum can be seen with loose bodies.

    – MRI is done for staging. Various methods to stage (not discussed here). MRI is important in the management plan.

  • Mx: conservative with NSAIDs and immobilization.¬†Surgical management (drilling, replacement of bone fragment, pinning etc) maybe done if fragments are unstable/displaced but the success rate only ~40%.
  • Late complication: secondary OA
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