{"id":23405,"date":"2022-01-20T13:29:44","date_gmt":"2022-01-20T17:29:44","guid":{"rendered":"http:\/\/osteomag.ca\/osteochondritis-dissecans\/"},"modified":"2023-11-13T22:59:19","modified_gmt":"2023-11-14T02:59:19","slug":"osteochondritis-dissecans","status":"publish","type":"post","link":"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/","title":{"rendered":"Osteochondritis dissecans (OCD) of the knee"},"content":{"rendered":"\n<p class=\"has-white-color has-vivid-cyan-blue-background-color has-text-color has-background\">Osteochondritis dissecans (OCD) is a condition where part of the joint cartilage surface dies due to lack of circulation. Necrosis of the subchondral bone forms. A necrotic bone fragment can break away from the joint surface and end up in the joint as a foreign body and damage the joint capsule. Such a fragment usually has a diameter of 1 to 2 cm.<\/p>\n\n<p>Synonym: Osteochondrosis<\/p>\n\n<p>Osteochondrosis can affect the knee, hip, elbow, foot and also the spine, but it most often affects the knee (85% are in the medial femoral condyle). When it affects the knee, it is called K\u00f6nig&#8217;s disease or epiphyseal osteochondritis of the lateral femoral condyle. It is an osteonecrosis mainly of the medial condyle of the knee. This lesion is usually located on the posterior lateral aspect of the medial femoral condyle (70% of them).&#13;\n<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion.jpg\" alt=\"\" class=\"wp-image-31498\" width=\"443\" height=\"300\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion.jpg 886w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-540x366.jpg 540w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-80x54.jpg 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-768x520.jpg 768w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-150x102.jpg 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-300x203.jpg 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-600x406.jpg 600w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-696x471.jpg 696w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/lesion-620x420.jpg 620w\" sizes=\"(max-width: 443px) 100vw, 443px\" \/><\/figure><\/div>\n\n<p>This osteochondritis becomes dissecting, as a separation of a fragment of bone and cartilage from the rest of the articular surface, occurs in a progressive way, to end up detaching completely, walking freely in the joint.&#13;\n<\/p>\n\n<div class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #000000;color:#000000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #000000;color:#000000\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/#Risk_factors\" >Risk factors<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/#Symptoms\" >Symptoms<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/#Sports_that_can_damage_the_cartilage_surface_of_the_hip\" >Sports that can damage the cartilage surface of the hip<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/#Screening_test\" >Screening test<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/#Wilson_test\" >Wilson test<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/#Radiography\" >Radiography<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/osteomag.ca\/en\/osteochondritis-dissecans\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\" id=\"causes\"><span class=\"ez-toc-section\" id=\"Risk_factors\"><\/span>Risk factors<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The exact cause has not yet been found, but possibly is a set of circumstances brought together by the following factors:&#13;\n<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>When the bone under the cartilage is injured, the blood supply can be restricted (ischemia); this can lead to the death of bone tissue (necrosis), causing the cartilage to fragment and dislodge.<\/li><li>Hereditary and endocrine factors<\/li><li>Avascular necrosis (loss of blood flow)<\/li><li>Lack of vitamin D<\/li><li>Minor trauma<\/li><li>Rapid growth<\/li><li>Deficiencies and imbalances in the calcium\/phosphorus ratio<\/li><li>Bone formation deciency<\/li><\/ul>\n<\/div><\/div>\n\n<h2 class=\"wp-block-heading\" id=\"symptomes\"><span class=\"ez-toc-section\" id=\"Symptoms\"><\/span>Symptoms<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<ul class=\"wp-block-list\"><li>The nature of the pain depends on the pressure exerted on the hip and, in the presence of a bone fragment, it can be instantaneous and paralyzing. This fragment of cartilage that is free in the joint capsule will cause a lot of damage and inflammation in its passage.<\/li><li>Pain related to activity that develops gradually.<\/li><li>Feel the joint that catches, blocks, that makes popping noises<\/li><li>Restriction of range of motion<\/li><\/ul>\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Sports_that_can_damage_the_cartilage_surface_of_the_hip\"><\/span>Sports that can damage the cartilage surface of the hip<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<ul class=\"wp-block-list\"><li>Gymnastic<\/li><li>Soccer<\/li><li>Basketball<\/li><li>The Crosse<\/li><li>Football<\/li><li>Tennis<\/li><li>Squash<\/li><li>Baseball<\/li><li>Weightlifting<\/li><\/ul>\n\n<p><\/p>\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Screening_test\"><\/span>Screening test<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Wilson_test\"><\/span>Wilson test<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n<figure class=\"wp-block-image size-full is-style-default\"><img decoding=\"async\" width=\"188\" height=\"199\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/2022-09-29_16-55-55.jpg\" alt=\"\" class=\"wp-image-32905\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/2022-09-29_16-55-55.jpg 188w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/2022-09-29_16-55-55-76x80.jpg 76w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/2022-09-29_16-55-55-150x159.jpg 150w\" sizes=\"(max-width: 188px) 100vw, 188px\" \/><\/figure>\n\n<p>The Wilson test aids in the diagnosis of osteochondritis dissecans of the medial femoral condyle. The examiners place the knee at 90 degrees of flexion and internally rotate the tibia. When the knee is extended, the patient feels pain at approximately 30 degrees of flexion. External rotation of the tibia relieves pain.<\/p>\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Radiography\"><\/span>Radiography<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div><a href=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/Osteochondritis_dissecans_diagram.jpg\" class=\"td-modal-image\"><div class=\"wp-block-image is-style-default\"><figure class=\"aligncenter size-full\"><img decoding=\"async\" width=\"534\" height=\"401\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/Osteochondritis_dissecans_diagram.jpg\" alt=\"\" class=\"wp-image-32901\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/Osteochondritis_dissecans_diagram.jpg 534w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/Osteochondritis_dissecans_diagram-80x60.jpg 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/Osteochondritis_dissecans_diagram-150x113.jpg 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/Osteochondritis_dissecans_diagram-300x225.jpg 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/Osteochondritis_dissecans_diagram-265x198.jpg 265w\" sizes=\"(max-width: 534px) 100vw, 534px\" \/><figcaption>Osteochondritis (arrow), Credit,By Houghton, Kristin M (2007). &#8220;Review for the general practitioner: assessment of anterior knee pain&#8221;. Pediatric Rheumatology 5 (8). DOI:10.1186\/1546-0096-5-8., CC BY 2.0, https:\/\/commons.wikimedia.org\/w\/index.php?curid=4957724<\/figcaption><\/figure><\/div><\/a><\/div>\n\n\n\n<div class=\"wp-block-image is-style-default\"><figure class=\"aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/339px-Osteochondritis_Dissecans_lat.-medial-fem.-condyle.jpg\" alt=\"\" class=\"wp-image-32903\" width=\"385\" height=\"545\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/339px-Osteochondritis_Dissecans_lat.-medial-fem.-condyle.jpg 339w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/339px-Osteochondritis_Dissecans_lat.-medial-fem.-condyle-286x405.jpg 286w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/339px-Osteochondritis_Dissecans_lat.-medial-fem.-condyle-57x80.jpg 57w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/339px-Osteochondritis_Dissecans_lat.-medial-fem.-condyle-150x212.jpg 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/339px-Osteochondritis_Dissecans_lat.-medial-fem.-condyle-300x425.jpg 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/339px-Osteochondritis_Dissecans_lat.-medial-fem.-condyle-297x420.jpg 297w\" sizes=\"(max-width: 385px) 100vw, 385px\" \/><figcaption>&#8220;There is fragmentation of the lateral aspect of the medial femoral condyle consistent with osteochondritis dissecans. There are two bone fragments present. The largest measures 0.9 cm, the smaller measures 0.4 cm. No signs of bodies intra-articular. No signs of effusion.&#8221;Author: Kenneth T Blackner, Affiliation: Naval Medical Center PortsmouthEditor: Stephanie A Bernard, Affiliation: Naval Medical Center Portsmouth, Public domain, via Wikimedia Commons<\/figcaption><\/figure><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-image is-style-default\"><figure class=\"aligncenter size-full\"><img decoding=\"async\" width=\"360\" height=\"480\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/360px-Knee_1300270.jpg\" alt=\"\" class=\"wp-image-32899\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/360px-Knee_1300270.jpg 360w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/360px-Knee_1300270-304x405.jpg 304w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/360px-Knee_1300270-60x80.jpg 60w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/360px-Knee_1300270-150x200.jpg 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/360px-Knee_1300270-300x400.jpg 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2022\/09\/360px-Knee_1300270-315x420.jpg 315w\" sizes=\"(max-width: 360px) 100vw, 360px\" \/><figcaption>Presence of a detached body in the joint due to osteochondritis dissecans of the knee. Credit, \u00a9 Nevit Dilmen, CC BY-SA 3.0 https:\/\/creativecommons.org\/licenses\/by-sa\/3.0, via Wikimedia Commons<\/figcaption><\/figure><\/div>\n<\/div>\n<\/div>\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<ol class=\"wp-block-list\"><li>Edmonds EW, Polousky J. A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from K\u00f6nig to the ROCK study group. Clin Orthop Relat Res. 2013 Apr;471(4):1118-26. [PMC free article] [PubMed]<\/li><li>Crawford DC, Safran MR. Osteochondritis dissecans of the knee. J Am Acad Orthop Surg. 2006 Feb;14(2):90-100. [PubMed]<\/li><li>Kocher MS, Tucker R, Ganley TJ, Flynn JM. Management of osteochondritis dissecans of the knee: current concepts review. Am J Sports Med. 2006 Jul;34(7):1181-91. [PubMed]<\/li><li>K\u00f6nig F. The classic: On loose bodies in the joint. 1887. Clin Orthop Relat Res. 2013 Apr;471(4):1107-15. [PMC free article] [PubMed]<\/li><li>Lind\u00e9n B. The incidence of osteochondritis dissecans in the condyles of the femur. Acta Orthop Scand. 1976 Dec;47(6):664-7. [PubMed]<\/li><li>Cruz AI, Shea KG, Ganley TJ. Pediatric Knee Osteochondritis Dissecans Lesions. Orthop Clin North Am. 2016 Oct;47(4):763-75. [PubMed]<\/li><li>Andriolo L, Crawford DC, Reale D, Zaffagnini S, Candrian C, Cavicchioli A, Filardo G. Osteochondritis Dissecans of the Knee: Etiology and Pathogenetic Mechanisms. A Systematic Review. Cartilage. 2020 Jul;11(3):273-290. [PMC free article] [PubMed]<\/li><li>Credit in part: Bryce Mohr;\u00a0John D. Baldea.<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Osteochondritis dissecans is a condition where part of the articular cartilage surface dies due to lack of circulation. This cartilaginous fragment formed may detach and damage the joint capsule.<\/p>\n","protected":false},"author":1,"featured_media":30643,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","iawp_total_views":1,"footnotes":""},"categories":[228],"tags":[],"class_list":{"0":"post-23405","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-knee"},"_links":{"self":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/23405","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/comments?post=23405"}],"version-history":[{"count":0,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/23405\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media\/30643"}],"wp:attachment":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media?parent=23405"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/categories?post=23405"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/tags?post=23405"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}