Osteochondritis dissecans commonly occurs in gymnasts and adolescent throwing athletes presenting with symptoms of lateral elbow pain associated with stiffness, catching, or clicking. The exact etiology is poorly understood but is thought to be related to high repetitive compressive forces causing alterations in the subchondral blood supply resulting in osteochondral fragmentation. The lateral localization of pain is also typical of osteochondritis dissecans of the elbow which usually occurs in the capitellum. Osteochondritis dissecans lesions can be evaluated by plain radiograph, MRI, and CT imaging. Early lesions demonstrate radiolucency on xray or non-displaced fragments, while advanced lesions show slightly displaced fragments and eventually large displaced fragments. Treatment while skeletally immature is best managed conservatively by cessation from sports followed by physical therapy. Arthroscopic debridement, loose body excision, and abrasion chondroplasty is indicated in patients who fail extended non-surgical treatment, have mechanical symptoms, or loose bodies on imaging. Takahara et al. published long term results showing poorer outcomes may be associated with advanced lesions, osteoarthritis of the elbow, and a large osteochondral defect.
Takahara M, Ogino T, Sasaki I, Kato H, Minami A, Kaneda K. Long term outcome of osteochondritis dissecans of the humeral capitellum. Clin Orthop Relat Res. 1999 Jun;(363):108-15.
PMID:10379311 (Link to Abstract)
OKU Sports Medicine 3. American Academy of Orthopaedic Surgeons; 3 edition (August 2004) Chapter 8;101.