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Osteochondritis dissecans

Última revisão: 19 Jun 2025
Última atualização: 12 Mar 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • history of ankle trauma
  • history of repetitive throwing or weight-bearing exercise of the upper extremity
  • history of competitive athletics
  • pain is exacerbated by activity
  • location of pain anteromedial aspect of the knee with the knee flexed to 90º
  • location of pain lateral aspect of elbow
  • location of pain posteromedial aspect of dorsiflexed ankle or anterolateral aspect of plantar-flexed ankle
  • effusion present
  • locking of joint
  • catching of joint
  • decreased range of motion
Detalhes completos

Outros fatores diagnósticos

  • knee involvement, age 10 to 20 years
  • elbow involvement, age 11 to 21 years
  • talus involvement, second to fourth decade
  • absence of history of trauma involving the knee or elbow
  • antalgic gait in osteochondritis dissecans involving the knee or talus
  • external rotation gait in osteochondritis dissecans involving the knee
  • relieving factors: nonsteroidal anti-inflammatory drugs (NSAIDS), rest, ice, elevation
  • crepitus
  • Wilson test
  • quadriceps atrophy
Detalhes completos

Fatores de risco

  • repetitive throwing/valgus stress
  • gymnastics/weight-bearing on upper extremity
  • ankle sprain/instability
  • competitive athletics
  • family history
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • knee radiographs
  • ankle radiographs
  • full-length lower extremity film
  • elbow radiographs
Detalhes completos

Investigações a serem consideradas

  • CT
  • MRI
  • MR arthrogram
  • diagnostic arthroscopy
Detalhes completos

Algoritmo de tratamento

AGUDA

knee

elbow

ankle (talus)

Colaboradores

Autores

Henry G. Chambers, MD

Professor of Clinical Orthopedic Surgery

University of California, San Diego

Rady Children’s Hospital

San Diego

CA

Declarações

HGC is an author of a number of references cited in this topic.

Agradecimentos

Dr Henry G. Chambers would like to gratefully acknowledge Dr James L. Carey, Dr Jon Divine, Dr Michael Nett, and Dr Cedric Ortiguera, the previous contributors to this topic.

Declarações

JLC is an author of a number of references cited in this topic. JD, MN, and CO declared that they had no competing interests.

Revisores

James E. McGrory, MD

Orthopedic Surgeon

The Hughston Clinic PC

Columbus

GA

Declarações

JEM declares that he has no competing interests.

Nicola Maffulli, MD, MS, PhD, FRCS(Orth)

Centre Lead and Professor of Sports and Exercise Medicine

Consultant Trauma and Orthopaedic Surgeon

Barts and The London School of Medicine and Dentistry

Institute for Health Sciences Education

Centre for Sports and Exercise Medicine

Queen Mary University of London

Mile End Hospital

London

UK

Declarações

NM declares that he has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Kocher MS, Tucker R, Ganley TJ, et al. Management of osteochondritis dissecans of the knee: current concepts review. Am J Sports Med. 2006 Jul;34(7):1181-91. Resumo

American Academy of Orthopaedic Surgeons. Diagnosis and treatment of osteochondritis dissecans. Dec 2023 [internet publication].Texto completo

Perumal V, Wall E, Babekir N. Juvenile osteochondritis dissecans of the talus. J Pediatr Orthop. 2007 Oct-Nov;27(7):821-5. Resumo

Baker CL 3rd, Baker CL Jr, Romeo AA. Osteochondritis dissecans of the capitellum. Am J Sports Med. 2010 Sep;38(9):1917-28. Resumo

Artigos de referência

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