Elbow Osteochondritis Dissecans

Elbow Osteochondritis Dissecans Description
Elbow Osteochondritis Dissecans is a cause of elbow pain in teenage (adolescent) athletes.  Throwing sports and other sports place very high forces on the elbow joint.  Repeated stress to the immature and still growing elbow.  The bone and cartilage in the elbow is still growing in young athletes and the high stresses can disrupt the blood supply and injure the bone and cartilage.   Injury to the bone andlittle league elbow xray cartilage in the joint is known as osteochondritis dissecans (OCD)

Osteochondritis dissecans of the elbow is also commonly referred to as Little League Elbow or Little Leaguer's Elbow because it is common in baseball pitchers.  It is also referred to as Panner's Disease and juvenile osteochondrosis. 

Elbow Osteochondritis Dissecans Anatomy
Elbow Osteochondritis Dissecans of the elbow involves the capitellum.  The capitellum is the area of the bone in the arm (humerus) which forms a joint (articulates) with the head of the radius (bone in the forearm).  In an adolescent the capitellum is still gowing.  The capitellar epiphysis (area of growth) has a tenous blood supply consisting of 2 vessels which enter posteriorly and transverse the cartilaginous capitellum. The arteries are called the Radial recurrent and interosseous recurrent arteries.  The capitellar articular cartilage is significantly softer than that of the radial head which may contibute to the developement of capittelar OCD.

Elbow Osteochondritis Dissecans Symptoms
Elbow Osteochondritis Dissecans causes pain and swelling in the elbow.   The may occur after a particular injury, but is much more common to gradually worsen over time without a specific injury.  Elbow osteochonritis dissecans causes soreness in the elbow which generally occurs during throwing or sports and often is relieved when not playing sports.

Elbow Osteochondritis Dissecans Treatment 
Elbow Osteochondritis Dissecans s diagnosed based on a detailed history, physical exam and xrays performed by an orthopaedic surgeon, or sports medicine specialist.  Osteochonritis of the elbow is generally diagnosed based on xrays which will demonstrate irrgularities in the capitellum or loose bodies.  MRI is helpful to define the extent of the OCD lesion and provide a definitive diagnosis in early cases when xray changes have not occured yet.

Treatment for osteochritis dissecans of the elbow is initially centered around avoiding the activity which is over stressing the elbow.  Athletes will need to stop their usual sport.  Icing and anti-inflammatory medications can be helpful as well. Offloading double-hinged elbow braces can be affective at relieving stress on the capitellum. 

In very mild cases athletes may be able to continue their sport, but change the offending activity.  Pitchers can play outfield for several weeks.  Pitches can also work with a throwing coach to ensure they are using proper mechanics in their throw.  Gymnasts can avoid activities which stress the elbow

In severe cases a period of complete rest in a sling or cast may be needed as well as a course of physical therapy. 

In advanced cases in which the osteochondritis dissecans is severe with a detached osteochondral fragment, or there are loose bodies often require surgery.  Surgery can involve elbow arthroscopy, microfracture, loose body removal, or grafting of the defect.  Surgery is best discussed with your surgeon. 

Athletes returning to sports after Elbow Osteochondritis Dissecans should begin with a graduated exercise program. First they should be pain free with daily activities with full range of motion and at least 85% strength in the injured elbow compared to the uninjured leg. Exercise begins with graduated return to throwing program over severe weeks.

Elbow Osteochondritis Dissecans Prevention
Prevention of Elbow Osteochondritis Dissecans

Elbow Osteochondritis Dissecans Risk Factors
Elbow Osteochondritis Dissecans is associated the following sports: Baseball; Basketball;  Dance;  Football; Gymnastics; Raquet sports.

Elbow Osteochondritis Dissecans Rehab and Exercise Program
Elbow Osteochondritis Dissecans

Elbow Osteochondritis Dissecans Outcomes
Elbow Osteochondritis Dissecans if identified early can resolve completely.  More advance cases may progress to elbow arthritis with loss of motion and pain in the elbow even with surgical treatment.

Similar injuries that can be confused with Elbow Osteochondritis Dissecans include:
 

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