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Osteochondritis Dissecans

 

 

  • Sub-articular, post-traumatic necrosis

  • Occurs only on convex surfaces of bone

    • Medial condyle of femur

    • Capitellum

    • Proximal surface of talus

    • Head of 1st metatarsal

  • Most patients are athletic

  • Direct blow is more common cause than a rotational injury

    • Knee lesions are more common amongst high jumpers

  • Most common cause of an intra-articular loose body

  • In adults, loose body contains larger fragment of cartilage than bone

  • Possible outcomes

    • Death of bony, but not cartilaginous, portion of loose body

      • Loose body is invisible except to MRI

    • Complete resorption of loose body

    • Reincorporation or regrowth

      • Usually not in adults

      • In children, fragment is less likely to separate from bone and therefore more likely to reincorporate

  • Cause of a “locking knee”

 

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