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Osteochondritis dissecans (OCD) most commonly affects the elbow at the capitellum, and typically involves the
area covered by the radial head at around 45° elbow flexion. Although the exact mechanism
of injury is unclear, OCD is thought to result from repetitive microtrauma to a poorly
vascularized capitellar chondroepiphysis. Unlike Panner disease, which most commonly
occurs atraumatically in young boys,
OCD of the capitellum is seen in teenage boys and girls involved in sports that tend
to generate high joint-reaction forces at the radiocapitellar joint (pitching, gymnastics,
wrestling, etc).
An anteroposterior, lateral, and 45° flexion oblique view will often demonstrate
focal radiolucency of the capitellum (Fig. 1). Magnetic resonance imaging can be helpful in assessing the status of the articular
cartilage (Fig. 2) and identifying signs of fragment instability and/or loose bodies.
Figure 1A Anteroposterior and B lateral radiographs demonstrate a focal radiolucency at the capitellum (white arrows)
consistent with an osteochondritis dissecans lesion with bone loss.
(Courtesy of Shriners Hospital for Children–Philadelphia.)
Comparison of osteochondral autologous transplantation, microfracture, or debridement techniques in articular cartilage lesions associated with anterior cruciate ligament injury: a prospective study with a 3-year follow-up.
Ten-year follow-up of a prospective, randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint of athletes.
