Osteochondritis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.


Overview

Osteochondritis dissecans (sometimes spelled dessecans, and abbreviated "OCD") is a painful condition within a joint of the body in humans or animals, in which fragments of cartilage or bone have become loose within a joint, leading to pain and inflammation. These fragments are sometimes referred to as "joint mice" due to a squeaking sound sometimes resulting from the joint. Specifically, OCD is a type of osteochondrosis in which a lesion has formed within the cartilage layer itself, giving rise to secondary inflammation. It has a complex etiology, and can be caused by genetic, hormonal, environmental and nutritional factors.

OCD can often be treated surgically.

General

OCD occurs when a loose piece of bone or cartilage separates from the end of the bone, often because of a loss of blood supply and insufficient amounts of calcium. The loose piece may stay in place or slide around making the joint stiff and unstable. OCD in humans most commonly affects the knees or ankles, but can also affect other joints such as the elbow. If a serious injury occurs in this area, the bone around it will supply it with as much calcium as possible to try and fix the loose piece of bone. This often results in a calcium build up around the loose piece. This build up is surgically removed most of the time.

The term "dessicans" refers to the "creation of a flap of cartilage that further dissects away from its underlying subchondral attachments (dissecans)" [2]

OCD has been associated both to too little, and too much, calcium in the body.

OCD is a relatively rare disorder. It commonly occurs in boys and young men from 10-20 years of age while they are still growing. As girls become more active in sports, it is becoming more common among them as well. Prevalence In knee, 30–60 cases per 100,000 population

Causes

Causes by Organ System

Cardiovascular Ischemia
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Acan mutation
Hematologic Calcium deficiency, Kienbock disease
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic Aseptic necrosis of bone, Avascular necrosis, Blount disease, Calcium deficiency, Freiberg disease, Humerus juvenile osteochondritis, Iselin disease, Juvenile osteochondrosis of head of femur, Juvenile osteochondrosis of spine, Kienbock disease, Kohler first disease, Osgood-schlatter disease, Physical trauma, Repetitive strain injury, Sever disease, Sinding larsen-johannson disease
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Avascular necrosis, Blount disease,
Sexual No underlying causes
Trauma Osgood-schlatter disease, Physical trauma, Repetitive strain injury
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Diagnosis

To determine whether your pains are osteochondritis dissecans, an MRI or X-Ray can be performed to show whether the loose piece of bone is still in place. In specific cases if caught early enough, a harmless dye will be injected into your blood stream to show where the calcium will most likely continue to build up. Doing this makes the removal process much easier..

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