Elbow OCD
Learning about osteochondritis dissecans of the elbow can help ease worries and make you or your child feel more prepared for treatment. Understanding the condition also supports informed decision making about care. This page brings together answers to common questions, insights drawn from real patient experiences, and trusted resources for those who want to explore the topic further.
Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. This softening is caused by an interruption in the blood flow to that portion of bone. Over time, if left untreated, this can lead to damage to the overlying cartilage of the joint. Loose pieces of bone and cartilage can even break off into joint. Long term ramifications may even include arthritis.
Osteochondral fracture (when a piece of bone that also contains joint cartilage breaks off in the joint) or chondral injury (an injury just to the cartilage in the joint) is similar to OCD, but it is generally caused by an acute injury to the cartilage and underlying bone. It can happen in association with ligament injuries, such as tearing of the ACL. OCD (osteochondritis dissecans), on the other hand, is considered a chronic process that can go on for months to years before any symptoms are felt.
OCD is a relatively rare problem, likely affecting far less than 1 percent of the population.
Treatment for elbow OCD depends on the patient’s age, growth status, and the stability of the lesion. Children and adolescents who still have growth remaining are often treated without surgery. This typically involves a period of rest from activities that place stress on the elbow, such as throwing or weight bearing through the arms, often for several months. Physicians may also recommend activity modification, physical therapy, bracing, or temporary immobilization to allow healing.
If the lesion does not heal with nonsurgical treatment, or if it is found to be unstable or at risk of breaking loose at the time of diagnosis, surgical treatment may be recommended. The specific surgical approach depends on the severity of the condition and is tailored to the individual patient.
The surgical choices to treat OCD depend on whether the OCD is firmly in place (stable) or threatening to loosen or dislodge (unstable). The following are a few examples of the many surgeries that are currently available to treat OCD.
X-Ray looks at bone. If the OCD involved the bone (which is under the cartilage), then the OCD will show up on X-Ray. There are special X-Ray views that your doctor may order to best see the OCD.
If the OCD does not show up on X-Ray, it may be because it only involves the cartilage. In this case, MRI scan will best show the OCD. MRI will also give more detail about the OCD, and may show whether the OCD is firmly in place (‘stable’) or not (‘unstable’), and whether it is healing or not.
Once an OCD is healed, we do not believe that they can “come back.” However, sometimes an OCD acts like it has healed, or looks like it has healed, when in fact it has not. In this case, there may be a misconception that the OCD has “come back.”
Elbow OCD can sometimes affect both elbows, although this is less common and varies from patient to patient. When bilateral involvement does occur, it may not cause symptoms on both sides at the same time.
At this time there is no clear evidence linking OCD of the elbow with OCD in other joints. Each joint is evaluated independently, and having elbow OCD does not necessarily mean that another joint will be affected.
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