MRI will help in the staging process and in determining the lesion’s healing potential.(1)
Pain & swelling are the first symptoms of osteochondritis dissecans.(2)
What Are The First Symptoms Of Osteochondritis Dissecans?
Osteochondritis dissecans is an orthopedic condition in which there is the fragmentation of the bone at one end due to a physiologic or pathologic process resulting in breaking off of a bone segment from the underlying long bone. It usually occurs in long bones and commonly used joints such as knee joint, ankle joint, elbow joint, etc.
The age group most commonly affected in osteochondritis dissecans is children and adolescents below the age of 18 to 20 years. It is a fairly slow process that may take years to present any of its symptoms. The etiology of the condition is not known completely but a variety of theories has been put forward to justify the pathology and its cause.(3)
When the process responsible for causing osteochondritis dissecans gets kicked off, the patient may or may not present with a variety of physical symptoms because it is a slow process and the presentation is variable. The most common symptom of presentation is a pain in the affected joint. It aggravates the usage of the involved joint and there may also be a restriction in the movement of the joint. It is because there are loose bone fragments found in the joint space and they can also produce a sound while they touch with the bone surface known as crepitus.
Another important symptom or in fact sign of osteochondritis dissecans is swelling around the affected joint. It may also occur because of the initiation of the inflammatory process after the loose bony fragment is rubbed off with the articular surface of the joint. There may also be some erythema if the condition presents in the acute phase with a very rapid progression.
Other symptoms of osteochondritis dissecans are mostly related to losing bodies that are found in the joint cavity which travels from one place to another within the cavity resulting in getting caught between two bones and locking them at an abnormal position. Sometimes the loose body may also travel just superficial to the skin as in case of the knee joint which will result in palpation of the loose body from outside. It may become a cause of stress in the patient and phobia of long-term illness may develop.
How Do You Test For Osteochondritis Dissecans?
For the testing of a patient suffering from osteochondritis dissecans, the most important testing is a physical examination of the patient. Although many of the patients give a history of repetitive trauma to the affected joint it is not a necessary factor in causation. As the most common joints involved are knee joint and ankle joint, the prominent sign encountered upon examination is difficulty in gait. The person is not able to walk properly because a loose body is present inside the joint cavity or a spinous process is impinging the other articular surface. Whereas when there is the involvement of elbow joint, swelling, and redness can be seen on the skin surface surrounding the elbow joint.(3)
For diagnosing a case of osteochondritis dissecans, radiological methods are used. X-ray of the affected joint may not be that helpful except in revealing the loose body is present in the joint. The second line investigation is a computed tomography scan of the joint to get a detailed view and proper look into the joint. While there is a current inflammatory or pathologic process is going on or not, it can be differentiated upon a magnetic resonance imaging scan. It is capable of differentiating a lower vascular and higher vascular area and can differentiate osteochondritis dissecans from osteonecrosis or avascular necrosis.(4)
Osteochondritis dissecans is exactly not an inflammatory condition and occurs because of repetitive trauma or impingement occurring at the site of involvement. It can be easily tested and diagnosed with the help of radiological investigations.