What is osteochondritis dissecans of the elbow?
Osteochondritis dissecans of the elbow is a disorder in which fragments of bone or cartilage come loose and float around in the elbow joint. Cartilage is tough, smooth tissue that lines and cushions the surface of the joints. These chips usually come from the upper arm bone (humerus).
The chips usually result from a forceful injury to the elbow joint or from a lack of blood supply to the bone. Throwing athletes and gymnasts may also have bone chips in the elbow.
Also known as
- Bone chips in the elbow
Symptoms
Dull pain at the elbow that is worse with activity but made better by resting it
Catching or locking at the elbow
Reduced range of movement at the elbow
Swelling at the elbow
Causes
This condition is often seen in younger people who engage in certain sports, such as:
Sports involving repetitive throwing (cricket, baseball)
Gymnastics
Football
Tennis
Basketball
Wrestling
It is a condition that seems to run in families – that is, there is a genetic predisposition to this condition.
Occasionally it is caused by a single traumatic event, such as a direct blow.
Risk Factors
Osteochondritis dissecans in the elbow is more likely to occur if you:
Are aged between 10 and 50 (especially if you are a teenager)
Are male (of all the people with this condition, approximately 85% are male)
Have other family members who have osteochondritis dissecans
Have other joints (i.e. knee) affected with osteochondritis dissecans
Play any of the sports listed in the “Causes” section
Investigations
To diagnose osteochondritis dissecans of the elbow, the following may be necessary:
X-ray – this shows up problems with bones quite well, and is a fast and simple test to do. The x-ray may not show anything wrong with the elbow initially because any changes that occur are very subtle.
CT scan – this can pick up more subtle changes in the elbow joint.
MRI – this shows both bone and soft tissue in the elbow (including cartilage) in very fine detail. It is especially useful in early diagnosis of the problem.
Ultrasound – this may be used to evaluate soft tissue structures. It may detect bone or cartilage chips floating freely in the joint.
Complications
Potential complications of this condition include:
Decreased range of movement at the elbow (reduced bending or straightening)
Pain with effort
Minor weakness at the elbow
Arthritis in the elbow
Treatment
The first treatment is to rest your elbow until the symptoms are gone. This may take up to a few weeks. You should put ice on the elbow for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain and swelling go away. Your healthcare provider may prescribe or recommend an anti-inflammatory medicine or other pain medicine. Small bone chips or cartilage fragments that do not affect elbow motion and do not cause further pain do not need to be removed. Surgery may be needed to remove larger fragments and to repair the injured joint surface.
Seeking Advice
Your Family Doctor (GP)
Your Family Doctor will be able to diagnose and help treat your problem. He or she will be able to
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
Prevention
Osteochondritis dissecans is usually caused by trauma to the elbow and is not preventable.
F.A.Q. | Frequently Asked Questions
How long will the effects last?
The symptoms may continue until surgery is done to correct the problem.
When can I return to my normal activities?
Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your elbow recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury. You may return to your activities when you are able to forcefully grip things, such as a bat or golf club, or do activities such as working at a keyboard without pain at your elbow. There should be no swelling around your injured elbow and it should have regained its normal strength compared to your uninjured elbow. You must have full range of motion of your elbow.