Osteochondritis Dissecans in the Elbow Symptoms & Treatment

Osteochondritis dissecans, also referred to as OCD of the elbow, is a disorder characterized by cracks in the articular cartilage or the lining of the elbow joint. When this cartilage loses blood supply, it can begin to wear down and crack, leading to damage to the underlying bone. Osteochondritis dissecans in the elbow most commonly occurs in the capitellum, the end of the humerus (upper arm bone) that is part of the elbow joint.

Osteochondritis dissecans occurs in athletes who are still growing, most commonly affecting adolescent athletes. The condition has four different stages of severity that are defined as follows:

• Stage I: The cartilage begins to thicken. At this stage, both the cartilage and bone are considered stable.
• Stage II: The cartilage begins to crack, but is still considered stable.
• Stage III: The cartilage has cracked completely and the underlying bone has begun to crack. The structure is considered unstable.
• Stage IV: The cartilage and/or bone has detached from its original position and is considered unstable.

The cause of osteochondritis dissecans of the elbow is unknown. However, scientists and physicians believe that it may be caused by repetitive trauma to the elbow. This can be a result of:

• Repetitive overhead motions, like throwing a baseball
• Bearing weight overhead, as is seen in gymnastics

Osteochondritis dissecans of the elbow are common in these sports:

• Baseball
• Softball
• Gymnastics
• Softball
• Tennis
• Volleyball

You may have osteochondritis dissecans of the elbow if you experience one or more of the following symptoms:

• Joint pain
• Stiffness
• Swelling
• A popping noise when moving the elbow
• Reduced range of motion
• Locking (occurs in later stages of the condition)

If you’re experiencing symptoms of osteoarthritis in the elbow, you may want to make an appointment with an orthopedic specialist. Your doctor will examine the elbow for pain, swelling, and tenderness, and assess range of motion.

In order to make a diagnosis, your doctor may prescribe the following imaging tests:

• X-ray
• MRI to rule out other additional injuries or problems

Early stages of osteochondritis dissecans are generally treated non-operatively, using conservative treatments. Non-operative treatments used to treat osteochondritis dissecans include:

• Resting the arm
• Icing the elbow throughout the day
• Immobilization for a short amount of time

If non-operative treatments have not been effective, or if osteochondritis dissecans is in a late stage, surgical treatment may be needed. Surgery to treat osteochondritis dissecans will depend on the stage of the disease. It is performed arthroscopically and may include:

Removing the fragment and drilling the bone to stimulate healing
Repairing the fragment with a screw (this method is used to repair large fragments)