What is Osteochondritis Dissecans of the Capitellum:
Osteochondritis dissecans (OCD) of the capitellum is a condition in which a small area of bone and the overlying cartilage in the elbow loses blood flow, weakens, and potentially separates over time. Osteochondritis dissecans most commonly affects the knee, elbow, and ankle. This condition frequently impacts adolescents, especially those who participate in overhead throwing sports like baseball or softball, as well as gymnasts. Lesions may be stable, or in more severe cases, become unstable and potentially break off.
Causes
The exact cause of OCD is unknown, but several factors can increase risk. Repetitive stress on the elbow, often from overhead throwing motions, is a common contributor. Prior injuries to the elbow may also make the joint more vulnerable. Young athletes who participate in high-impact or year-round activities, such as baseball, gymnastics, or tennis, are more likely to develop OCD.
Symptoms
Patients usually have elbow pain on the outer (lateral) surface that worsens with activity and improves with rest. Other symptoms include stiffness, reduced range of motion, or difficulty in completely straightening one’s arm. Occasionally, clicking or locking sensations can be heard with movement.
Diagnosis
The diagnosis of OCD is made by reviewing your symptoms and medical history and performing a physical examination of the elbow. Common imaging tests, such as X-ray and MRI, are often used to confirm the diagnosis, evaluate the stability of the bone and cartilage, and further characterize the OCD lesion.
Treatment
Treatment for OCD of the capitellum depends on the severity of the lesion and ranges from conservative to surgical management.
For smaller, stable lesions, treatment focuses on immobilization, often using a brace to allow the joint to heal. Additional measures may include physical therapy to strengthen the elbow, over-the-counter pain medications such as NSAIDs, and rest. Physical therapy is also used to strengthen the elbow and restore motion.
For more severe, unstable, or detached lesions, surgery may be necessary. Surgical options often include drilling to stimulate healing by increasing blood flow to the bone or debridement to remove damaged or loose tissue. Some procedures are needed to replace the bone and cartilage defect with new tissue either from the patient’s own tissue or from a cadaver. The overall goal of both non-surgical and surgical treatments is to relieve pain, restore strength, and maintain a full range of motion in the elbow.