Symptoms, causes and duration of osteochondritis dissecans

Osteochondritis dissecans is an injury that usually appears in the knee but can also affect other joints such as the ankle or chest. This pathology, which is common in children and adolescents who practice impact sports, usually has a simple treatment and a quick recovery, but in some cases a more complex treatment may be necessary.

In this article, we'll delve into this injury, recognizing its symptoms, causes, and available treatments.

What is osteochondritis dissecans?

Osteochondritis dissecans is a joint disease in which the bone beneath the cartilage dies or becomes necrotic due to lack of blood flow. This lack of blood flow can cause the affected bone, along with the cartilage that covers it, to fragment or detach, causing pain, inflammation, and difficulty moving the joint.

Although it can develop in different joints, the knee tends to be the most affected, accounting for 75% of cases.

Specifically, in this disorder, cracks form in the articular cartilage and the underlying subchondral bone. Thus, In osteochondritis dissecans, avascular necrosis may occur., which consists of the death of bone tissue due to lack of blood.

In general, Osteochondritis dissecans is a major cause of joint pain in physically active adolescentsHowever, because bones are still growing at this stage, they are more likely than adults to recover, as the bone's ability to repair damage or death of bone tissue (bone remodeling) into cartilage is greater.

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Symptoms of osteochondritis dissecans

The main symptoms of osteochondritis dissecans are:

• Pain in the affected bone and/or cartilage: This is the most common symptom and usually appears during or after physical activities such as running, climbing stairs, or playing sports. In some cases, the pain can be constant, even at rest.
• Joint inflammation: The affected joint may show visible swelling and tenderness. These signs often worsen after prolonged or repetitive use of the joint.
• Joint locking or clicking: When the fragment of cartilage or bone breaks off and remains inside the joint, it can cause temporary blockages or noises when moving the limb.
• Joint instability: A feeling of weakness or a feeling of the joint “giving way” may occur, especially when performing movements that require support or balance.
• Restriction in range of motion: The range of motion may be limited, making it difficult to extend or flex the joint, interfering with performing simple tasks such as bending down, walking, or raising the arms.

These symptoms will depend on the affected joint and the degree of progression of the injury.

Causes of osteochondritis

Although the exact causes that generate this injury are not entirely clear, there are different factors that are related to osteochondritis dissecans:

• Repetitive physical trauma
• Reduced blood flow to the bone (ischemia)
• Loss of blood flow (avascular necrosis)
• Small injuries to the joint
• Fast growth
• Calcium and phosphorus deficiencies and imbalance
• Genetic and endocrine factors

At the same time, Osteochondritis dissecans appears more frequently in children and adolescents between 10 and 20 years of age who do a lot of sports, especially impact sports.. This disorder is easily linked to high-impact sports such as football, basketball, lacrosse, tennis, squash, baseball, and weight lifting.

Most common types of osteochondritis

Osteochondritis dissecans is classified by specialists according to the size of the lesion, the degree of detachment of the affected fragment, and whether or not it remains in place. In cases where the detached fragment remains in place, the patient may experience few symptoms.

Depending on the area that is affected, There are different types of osteochondritis each of them with different causes and symptoms:

Osteochondritis knee

As we have mentioned, osteochondritis of the knee is the most common form and affects a segment of cartilage and its subchondral bone.The disease may be due to an unconsolidated osteochondral or subchondral fracture and usually occurs in the internal femoral condyle.

The most common symptoms include localized pain that worsens with physical activity, swelling around the knee, a popping or locking sensation, and partial loss of mobility. There may also be weakness or a feeling of instability when walking or putting weight on the leg.

If left untreated, knee osteochondritis can damage the cartilage, causing loose parts of the bone and cartilage to fall away from the joint. In turn, in the long term it could lead to arthritis.

Osteochondritis chest

Osteochondritis of the chest or costochondritis affects the cartilage that connects the ribs to the sternum.The main symptom is a sharp, stabbing pain in the front of the chest, which may increase with pressure, deep breathing, or certain movements. Sternum pain from osteochondritis is caused by inflamed cartilage, which causes chest pain.

This condition is also known as chest wall pain or costoesternal syndrome and is generally a harmless condition that usually goes away on its own after two or three days.

Sternal osteochondritis

Sternal osteochondritis, also known as Tietze's disease, is a painful type of osteochondritis characterized by benign inflammation of one or more cartilages of the sternocostal jointIt is differentiated from costochondritis by the presence of visible swelling in the affected area. The pain may be constant or intermittent, and in some cases, it may radiate to the neck, shoulder, or arm.

In some cases, the development of this disorder may be preceded by excessive coughing, vomiting, chest trauma, or infections. Tietze syndrome usually resolves within a few months with rest, but follow-up care may be required if symptoms persist.

Ankle osteochondritis

Ankle osteochondral injury is an injury to the cartilage of the articular surface that almost always affects the talus (tarsal bone that constitutes the lower part of the ankle).

The main cause of osteochondritis dissecans of the talus are ankle sprains.

Symptoms include persistent pain that worsens with physical activity, as well as swelling, stiffness, and sometimes a feeling of locking or instability in the ankle. This injury usually improves with rest, but if left untreated, it can worsen and limit the foot's ability to function.

Osteochondritis dissecans of the elbow

When this pathology appears in the elbow, it usually involves the articular surface of the capitellum, especially in young people who practice throwing sports or activities with repetitive arm movements.

Symptoms may be subtle at first, such as mild discomfort after exercise, but over time, localized pain, loss of strength, joint locking, and a clicking sensation when moving the elbow develop.

It is essential to differentiate it from Panner's disease, with which it shares similarities, although they differ in age of onset, prognosis, and treatment. An accurate diagnosis is key to avoiding long-term complications.

Diagnosis of osteochondritis

If you present symptoms associated with osteochondritis, you should go to a specialist so that a diagnosis can be made and the treatment that best suits the patient can be indicated.

The diagnosis of osteochondritis consists of a first physical examination in which the specialist will put pressure on the affected joint in order to analyze the ligaments, measure the range of motion and verify the sensitivity or inflammation of the area.

You can then indicate one or more imaging tests such as x-rays, MRIs, or CT scans, to obtain a more detailed picture of the affected joint.

Treatment for osteochondritis dissecans

The treatment prescribed to the patient will be aimed at relieving pain, promoting cartilage recovery and restoring normal joint function.The choice of treatment will depend on the patient's age, bone condition, size, and stability of the lesion.

Typically, especially in children, rest or a device to immobilize the joint for a period of time is sufficient. In most mild cases, conservative treatment may include:

• Absolute rest, preventing the joint from bearing weight or making movements.
• Interruption of physical activity, especially in sports or high-impact exercises.
• Use of immobilization devices, such as splints or knee braces, to protect the area.

Physical therapy may also be part of a conservative approach, especially to restore mobility and prevent loss of muscle strength. physiotherapy treatment for osteochondritis consists of:

• Range of motion exercises.
• Stretching exercises.
• Muscle strengthening exercises.

In more serious cases where a fragment remains loose or the area continues to be affected for some other reason, Osteochondritis surgery may be necessary. It is a minimally invasive surgery that helps restore tissues in a simple way.

H3. How long can osteochondritis last?

The duration of the osteochondritis It will depend on when treatment begins, the size of the injury and how mature the bones are.. In any case, the lesion usually disappears on its own, although there are cases in which it can last several weeks or longer.

For their part, children and adolescents - being in the growth stage - have an easier time recovering from osteochondritis.

How serious can osteochondritis dissecans be?

The severity of this injury varies depending on the patient's age, location, and size of the affected fragment or cartilage. In many cases, especially in young patients, it can be a mild condition that resolves with conservative treatment. However, in more advanced cases or when the fragment has become detached, surgical intervention may be necessary.

If osteochondritis dissecans is suspected, it is essential to consult a trauma specialist. Early diagnosis can prevent the injury from progressing and becoming more complicated, allowing for a simpler and faster recovery.

Prevention of osteochondritis dissecans

For prevent osteochondritis desiccant It is advisable to exercise the joints through movements that promote the stretching of the ligaments and supporting muscles.

Avoiding muscle overload in the gym and avoiding lifting a lot of weight in daily activities is also advisable to avoid osteochondritis, as well as good sports practice that includes an adequate warm-up beforehand.

Clinic for the treatment of osteochondritis dissecans in Madrid

As we have noted, if you suspect osteochondritis dissecans, it is essential to seek medical attention as soon as possible from a trauma specialist to avoid complications and achieve effective treatment.

In Elgeadi Clinic We have the most advanced technology and a team of traumatology specialists to make a good diagnosis and offer the solution that best suits the patient. Whether a conservative approach or surgery is necessary to restore the damaged joint, our team can provide the best possible treatment.

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