The elbow joint consists of various bones and tissues that are nourished by the blood supply from numerous arteries. Insufficient or loss of blood supply to these parts may lead to death of the bone and the articular cartilage that protects it. This condition is termed as the Osteochondritis Dissecans of the Elbow. The lower part of the humerus, Capitellum, is most commonly affected by the condition. It helps to rotate the palm and forearm.
In most cases, Osteochondritis Dissecans of the Elbow is observed in people aged 10-20 years who are particularly active in sports. The damage to the bone or the cartilage may be partial or complete. If it is partially affected, the problem may heal through conservative methods of treatment. However, in severe cases, the bone piece or cartilage tissue may get detached and begin floating within the joint spaces.
Causes
- People with a family history of Osteochondritis Dissecans are more likely to develop this condition
- Repeated injuries to the joint may eventually result in loss of blood supply (Avascular Necrosis)
- Indulging in sports that require excessive overhead movement, such as basketball, tennis, volleyball, gymnastics etc., may stress the elbow joint
- Occupations or activities that require lifting heavy weights
Symptoms
- Pain while bending or straightening the elbow
- Crepitus- a sensation or sound of bone cracking when the elbow is moved
- Swelling and tenderness
- Limited range of motion
- A feeling of the joint being unstable
Diagnosis
- Detailed clinical evaluation of the joint using palpation, visual analysis and moving the affected arm in different directions
- Family and medical history of the patient may be taken into consideration
- MRI or CT scans may be carried out to assess the exact location and severity of damage to the cartilage
- X-ray imaging may be done to examine the changes in bone structure
Treatment
- Immobilization of the joint using a brace, splint, sling or cast
- The patient may be required to abstain from any activity that causes puts stress on the elbow. This is usually recommended in cases where the bone or cartilage is partially damaged. The patient, being in the growth phase, tends to develop new bone mass and cartilage tissue that repairs the damaged one
- Physical therapy may be recommended to maintain joint health and flexibility
- Corticosteroid injections may be administered directly into the joint for immediate relief
- Surgical removal of the damaged bone mass or cartilage
- Arthroscopic surgery to drill holes into the bone to increase blood supply to the affected area and promote cartilage growth
- Loose parts of the bone may be held in place using screws and pins
- Bone and cartilage graft- A piece of healthy bone or cartilage tissue may be extracted from another part of the body and planted in place of the damaged ones to regain functionality of the joint