A 17 year old Arkansas male presents complaining of knee pain since the age of 14. Patient states initially diagnosed with growing pains, subsequently an MRI confirmed diagnosis of OCD or Osteochondritis Dissecans. He initially had surgery on the left knee over a year ago followed by arthroscopy and surgery on right knee 2 months ago.

The right knee continues to swell and ache him on day to day basis. Past Medical history is unremarkable, Patient was involved with sports activity up to his knee pain started.

Patient has been told he may need  surgeries and possible  total knee replacement in future.

 

Discussion:

This is typically seen in adolescent males, Osteochondritis Dissecans (OCD) is an entity seen at the ossification centers of the bone (these areas are responsible for the development of new bone). The OCD mostly develops in the knee joint. Sometimes a fragment of cartilage separates from the joint surface. The cause is uncertain, but trauma and ischemia have been explained to be the etiology or cause of Osteochondritis Dissecans. As mentioned in earlier articles certain parts of the joints specifically the cartilage has poor blood supply and circulation and is prone to ischemia (medical lingo: Ischemia is a condition in which blood flow - and thus oxygen - is restricted to a part of the body) and possible necrosis (medical lingo: Necrosis means death of tissue in the body)

Common symptoms are pain and swelling of the joint. MRI is helpful in diagnosis of this ailment. Treatment should be directed towards increase of blood flow by means of possibly angiogenesis. Although less common, elbows and ankles are other sites of OND.