Review Question - QID 2914

This child has osteochondritis dissecans (OCD) of lateral femoral condyle with open growth plates.

More than 70% of JOCD lesions are found in the “classic” area of the posterolateral aspect of the medial femoral condyle, with inferior-central lateral condylar lesions accounting for only 15% to 20% of cases and femoral trochlear lesions seen in less than 1%. The knee is the most common site of osteochondrosis in growing children, which is seen in an estimated 0.002% to 0.003% of knee radiographs.

The cited review by Schenck and Goodnight concluded that the outcomes of distal femur OCD in skeletally immature patients are good and these lesions usually heal without surgical treatment. Limitation of activity may diminish stresses across the OCD lesion and prevent displacement. Only about 15% of juvenile OCD cases present in the lateral femoral condyle with the majority occuring in the lateral aspect of the medial femoral condyle. In adult patients, the rate of non-operative healing is very low. Other indications in this child for operative intervention would be failure of non-operative treatment, mechanical locking from a loose body, or radiographic evidence of a displaced fragment.