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
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