Majority of patients are adolescent or young adult athletes.
Main joints involved include the knee, ankle, and radiocapitellar joint of the elbow.
Bilateral in up to 25%.
Variable presentation: traumatic or atraumatic, insidious onset, nonspecific joint pain, exacerbation of symptoms with exercise (especially stair- or hill-climbing), recurrent effusion, catching or locking.
Radiographs: minimum of 2 views of the involved joint (more specified for knee and ankle) performed for diagnosis.
While the etiology remains unclear, early recognition is essential as many treatment options exist.
Osteochondritis dissecans is an acquired, potentially reversible idiopathic lesion of subchondral bone resulting in delamination and sequestration with or without articular cartilage involvement and instability. It is increasingly seen as the cause of joint pain in adolescent and young adult athletes, thought to be due to earlier and higher-demand participation in competitive sports. However, no clear evidence is available to support this belief, and despite much speculation the cause of both juvenile and adult osteochondritis dissecans remains unclear.
Professor of Clinical Orthopedic Surgery
University of California, San Diego
Rady Children’s Hospital
HGC has acted as a consultant to OrthoPediatrics, undertaken research for Allergan, and is an associate editor for Developmental Medicine and Child Neurology. HGC is an author of a number of references cited in this topic.
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. JLC is an author of a number of references cited in this topic. JD, MN, and CO declare that they have no competing interests.
The Hughston Clinic PC
JEM declares that he has no competing interests.
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
NM declares that he has no competing interests.
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