Osteochondritis
Osteochondritis | |
---|---|
Classification and external resources | |
Specialty | rheumatology |
ICD-10 | M93.9 |
ICD-9-CM | 732.9 |
DiseasesDB | 9320 |
MeSH | D010007 |
Osteochondritis is a painful type of osteochondrosis where the cartilage or bone in a joint is inflamed.[1]
It often refers to osteochondritis dissecans (sometimes spelt dedessecansand abbreviated OCD). The term didissecans refers to the "creation of a flap of cartilage that further dissects away from its underlying subchondral attachments (dissecans.[2]
The other recognized types of osteochondritis are osteochondritis deformans juvenilis (osteochondritis of the capitular head of the epiphysis of the femur)[1] and osteochondritis deformans juvenilis dorsi (osteochondrosis of the spinal vertebrae, also known as Scheuermann's disease).[1][3]
Osteochondritis, and especially osteochondritis dissecans, can manifest in animals as a primary cause of elbow dysplasia, a chronic condition in some species and breeds.[4]
The most common joints affected by Osteochondritis are the knee, ankle, and elbow, although it can occur in other joints. Though it mostly affects one joint, some children may develop osteochondritis in several joints. In many cases of osteochondritis in children, the affected bone and cartilage heal on their own, especially if a child is still growing. In grownup children and young adults, osteochondritis, can have more severe effects.[5]
Anatomy
A joint is where the two parts of the bones are fitted together, for example, knee, ankle, or shoulder joints. Articular cartilage is the highly specialized tissue that covers the ends of bones where they come together to form joints. Cartilage makes it easier to move and allows the bones to glide over each other with very little friction. Osteochondritis is most commonly seen in the knee joint at the end of the femur (thighbone).[6]
Causes
While this disease can develop without any exact cause,most probable causes are listed below.[7]
- Trauma
- Vascular (decreased blood supply to bone)
- Genetic
- Repetitive stress on joints
Symptoms
The affected joint has following symptoms:[5][6]
- Pain: triggered by physical activity walking up stairs, playing sports.
- Swelling/tenderness:
- Joint popping or locking: joint might pop or stick in one position if a loose fragment gets caught between bones during movement.
- Decreased range of movement: You may be unable to straighten the affected limb completely, leading to limb weakness.
Diagnosis
Your doctor takes complete medical history and a physical examination of the affected joint. Other tests which may help your doctor confirm a diagnosis include X-Ray and MRI. X-Ray shows detailed pictures of dense structures, like bone. An x-ray of the affected joint is essential for an initial osteochondritis diagnosis, and to evaluate the size and location of the osteochondritis lesion. MRI can help your specialist to assess the extent to which the overlying cartilage is affected.[6]
Conservative Treatment
Osteochondritis treatment aims to establish the correct functioning of the affected joint and to relieve pain and reduce the risk of osteoarthritis. In children whose bones are still growing stage, the deformities can be cured by a period of rest and protection. Initially, your doctor may likely recommend conservative measures, which might include:
Resting your joint: Avoid activities that stress you are joint, such as jumping and running if your knee is affected. You might need to use crutches for a time, especially if pain causes you to limp. Your doctor might also suggest wearing a splint, cast or brace to immobilize the joint for a few weeks.[5][8]
Physiotherapy: This is one of the most important treatments for almost all orthopedic conditions and includes:
- decreasing pain through various modalities
- increase strength, regain mobility to the affected joint
Physiotherapy is commonly recommended after surgery, as well.[8]
Surgical Treatment
There are different surgical techniques for treating osteochondritis, depending upon the individual case:
- Drilling into the lesion to create pathways for new blood vessels to nourish the affected area
- Replacing the damaged affected part with a new piece of bone and cartilage grafts
- Holding the lesion in place with internal fixation (such as pins and screws)
In general, crutches are required for about six weeks after surgical treatment, followed by a 2- to 4-month course of physiotherapy to regain strength and motion in the affected joint. A gradual return to sports may be possible after about 4 to 5 months.[6][7][8]
Prevention Tips
Teens who participate in organized sports could benefit from education on the risks to their joints associated with overuse.[5]
- Learn the mechanics and techniques of the sport
- Using the appropriate protective equipment
- Participation in strength training exercises and stability training can help reduce the risk of injury.
Notable persons with osteochondritis
- Liam Coyle, Northern Irish footballer
- Bryce Davison, American-Canadian pair skater
- Donna Gurr, Canadian swimmer
- Michael Russell, American tennis player
- Kristina Vaculik, Canadian artistic gymnast
- Jonathan Vilma, American NFL football linebacker
- Luis Zubeldía, Argentine footballer
See also
References
- 1 2 3 "Osteochondritis" at Dorland's Medical Dictionary
- ↑ "CAL > Home". cal.vet.upenn.edu. Retrieved August 20, 2015.
- ↑ Scheuermann's disease at the US National Library of Medicine Medical Subject Headings (MeSH)
- ↑ Quoted from: Matthew Pead and Sue Guthrie. "Elbow Dysplasia in dogs – a new scheme explained" (PDF). British Veterinary Association (BVA). Retrieved 2010-07-16.
- 1 2 3 4 De Franceshi, L; Grigolo, B; Roseti, L; Marconi, E; Facchini, A (Jul 1, 2007). "Osteochondritis dissecans". Histopathology, Volume 51 (1).
- 1 2 3 4 Sanders, Richard K; Crim, Julia R (Aug 1, 2001). "Osteochondral Injuries". Seminars in Ultrasound, CT, and MRI, Volume 22 (4).
- 1 2 DellaMaggiora, Ryan; Vaishnav, Suk; Vangsness, C. Thomas (Apr 1, 2008). "Osteochondritis Dissecans of the Adult Knee". Operative Techniques in Sports Medicine, Volume 16 (2).
- 1 2 3 "Surgical Treatment Options for Osteochondritis Dissecans of the Knee".
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