At the elbow
Osteochondrosis dissecans of the elbow is probably caused by a circulatory disorder of a part of the elbow bone. Another hypothesis is that osteochondrosis dissecans of the elbow is caused by an overload reaction of the bone as a result of extreme and frequent arm movements (e.g. during throwing movements during sports). In most cases, osteochondrosis dissecans affects the outer humeral roll (capitulum humeri), but it can also occur at the spoke head (caput radii) or at the inner humeral roll (trochlea humeri).
In osteochondrosis dissecans of the elbow, varying degrees of pain are felt in the affected elbow, and cracking or rubbing, blockages or entanglements may also occur. The diagnosis is usually made by means of an x-ray of the elbow joint. More sensitive is the imaging of the elbow by means of magnetic resonance imaging (MRI), since it can also show earlier stages of osteochondrosis dissecans.
The course of the disease can vary greatly. In some cases, osteochondrosis dissecans of the elbow is unproblematic and has no consequences, and the disease can also leave severe permanent traces. Osteochondrosis of the elbow has a favorable prognosis, the younger the person affected is, if the growth plate of the outer upper arm roll is still open and the smaller the spatial extent of osteochondrosis dissecans.
Therapy consists of a break from sports, the administration of anti-inflammatory drugs, and if necessary a plaster cast for a few days. Surgery may become necessary if the osteochondrosis dissecans at the elbow deteriorates, the affected bone area threatens to detach, or a free joint body (piece of bone that “floats” freely in the joint) has developed. An MRI is an imaging procedure to show the structure and function of the tissues and organs in the body.
An MRI machine generates very strong magnetic fields that excite certain atomic nuclei in the body and induce an electrical signal. It does not generate any harmful X-rays or other ionizing radiation.An MRI examination is the most reliable way of diagnosing osteochondrosis dissecans and helps to determine the stage of the disease. An X-ray often shows the typical changes long after the actual circulatory disturbance, which is why the diagnosis is often made late.
Before MRI examinations were possible, osteochondrosis dissecans was only discovered when the affected piece of cartilage-bone (joint mouse, dissecate) was detached, as this caused blockages. With the aid of magnetic resonance imaging (MRI), the position and size of the osteochondrosis dissecans, the depth of the dissected cartilage and, above all, the involvement of the cartilage above it can be precisely measured. This also allows statements to be made about the stability of the affected joint.
MRI is also very suitable for monitoring the course of the disease, but simple X-ray examinations can also be performed if necessary. An MRI should always be performed on both sides, since osteochondrosis dissecans occurs on both sides in about 40 percent of cases. The diagnosis of osteochondrosis dissecans includes a detailed anamnesis (medical history).
The physical examination will rule out other possible diseases (differential diagnoses) as far as possible. There is no specific examination technique with which osteochondrosis dissecans can be reliably diagnosed. Recurring blockage symptoms in advanced osteochondrosis dissecans caused by a trapped joint mouse are indicative. However, the same phenomenon is also found in certain forms of meniscus injury and in free joint bodies of other causes (e.g. chondromatosis).
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