Osteochondritis Dissecans is a disorder in which a fragment of cartilage and subchondral bone seperates from an articular surface. The etiology is uncertian, although trauma and ischemia have been implicated. The knee is most commonly affected, but the elbow and ankle may also be involved. Patients typically present during their adolesent or early adult years with nonspecific knee pain and swelling that worsens with activity. The diagnoses is confirmed by radiographic findings. Managment decisions are based on the patients age and the stability, location, and size of the lesion.
SURGICAL TREATMENT- Surgery may be needed for young patients with stable lesions of the medial femoral condyle if consevative therapy fails to relieve symptoms or if there is no radiographic evidence of healing after 12 weeks. Surgical repair is recommended for adult patients regardless of the stability of the lesion. Unstable fragments require surgery regardless of the patients age.
Clinical findings- Patients with OCD of the knee, Typically with poorly localized, aching pain and swelling. Symptoms of knee locking or giving may develope as the disease progresses. The pain is brought on by strenous activity and twisting motions, especially internal rotation of the tibia. As a result, patients may walk with the effected leg externally rotated.
Healing knees- The goal of returning patients to activity is most easily achieved for children and adoescents and for those who have stable lesions of the medial femoral condyle. For these patients, brief immobilization, followed by limited activity. Soft tissue uptake of these radiopharmaceuticals will occur in certain instances. In rhabdomyolysis, uptake is believed to be secondary to cell death. In some cases a bone scan is necessary to diagnose rhabdomyolysis. It will also show the extent of the injury.