Osteochondritis dissecans. Osteochondritis dissecans of the capitellum is a well-recognized cause of elbow pain and disability in the adolescent athlete. 32.2 ). In the elbow, supplemental views such as 45 degrees flexion or oblique views may help to demonstrate the lesion. Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone separates from the end of the bone because of inadequate blood supply. THE ALFRED I. DUPONT INSTITUTE . Although radiography is a crucial initial imaging study, its sensitivity for detection of capitellar OCD is as low as 66% according to one study ( ). Arthroscopic treatment of osteochondritis dissecans of the capitellum: Report of 5 female athletes. The separated fragments are sometimes called “joint mice”. J Hand Surg Am. Investigators have found high sensitivity (89% to 100%) of MRI for detecting unstable lesions when all four of the following Kijowski criteria are present: (1) a rim of high signal on T2-weighted images, (2) surrounding cysts, (3) a fluid-filled osteochondral defect, and (4) a thin high-intensity fracture line on T2-weighted images ( ). CRAIG MORGAN, M.D., Attending, Orthopaedic Surgery. Osteochondritis dissecans of the capitellum. Unfortunately, the prognosis for advanced lesions remains more guarded, but short-term results after newer reconstruction techniques are promising. Many classification systems have been proposed to help guide the diagnosis and management of capitellar OCD lesions.  |  Osteochondral Autograft Transfer for Capitellar Chondral and Osteochondral Defects. A disadvantage to consider with CT is the radiation exposure imparted on the young athlete. In book: Sports Injuries of the Elbow (pp.63-72) Authors: Christiaan J A van Bergen. A major disadvantage of ultrasound is the high variability in its accuracy, which is based on the skill and experience of the operator ( ). Osteochondritis dissecans (OCD) of the humeral capitellum is a critical elbow injury in adolescent overhead throwing athletes. Throwers, overhead athletes, and upper extremity weight bearing athletes (gymnasts) are at higher risk of capitellum OCD lesions. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. If conservative treatment is not possible or fails, surgical options include open debridement with fragment excision, arthroscopic debridement and marrow stimulation, fragment fixation, closing wedge osteotomy of the distal humerus, osteochondral autograft, and osteochondral allograft. Int J Sports Phys Ther. Bexkens R, Oosterhoff JHF, Tsai TY, Doornberg JN, van den Bekerom MPJ, Eygendaal D, Oh LS. 1. repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity 1.1. valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the etiology for OCD of the capitellum 8 2. ankle sprain/instability 2.1. COVID-19 is an emerging, rapidly evolving situation. Ultrasonography is another potential diagnostic imaging tool for capitellar OCD. OCD can mean one or more flakes of articular cartilage have become separated. Capitellar OCD is relatively uncommon but 13. Rest and antiinflammatory medications are typically effective in relieving the pain, features that may contribute to the delayed presentation that often occurs with this pathology. eCollection 2017 Dec. Osteochondritis dissecans of the humeral capitellum. Elbow is flexed 110 to 120 degrees, and the shoulder is slightly externally rotated. However, we are very careful with this treatment arm of the algorithm because the elbow loses functional range of motion faster than most joints in the body when it is immobilized. Patients may also complain of accompanying elbow stiffness and loss of motion. With this maneuver, passive forearm pronation and supination with the elbow in midrange flexion and extension during application of an axial load recreates pain at the radiocapitellar joint. Nonoperative treatment for osteochondritis dissecans of the capitellum. Unfortunately, the ability to prognosticate when conservative treatment will be successful is not well established, and the decision whether to initiate nonoperative versus operative management in capitellar OCD focuses on the extent of disease, the time from onset of symptoms, and the patient’s expectations and desires. Patients who present with OCD of the capitellum are typically athletes between ages 11 and 21 years ( ). This condition typically affects young athletes, such as throwers and gymnasts, involved in high-demand, repetitive overhead, or weightbearing activities. Osteochondritis dissecans (OCD) of the capitellum is a condition of the lateral elbow that often affects skeletally immature athletes, especially those who repeatedly subject the radiocapitellar joint to compressive forces. J Shoulder Elbow Surg. 32.4 ). In the evaluation for suspected osteochondritis dissecans of the capitellum, standard elbow radiographs, including anteroposterior (AP), oblique radial head, and lateral views, should be obtained ( Fig. Osteochondritis dissecans (OCD) of the humeral capitellum is a sports-related disorder in young athletes, especially baseball players and gymnasts. 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