17 Questions
What is the primary purpose of an X-ray in diagnosing OCD?
To determine the size and location of the OCD lesion
In what cases may surgical treatment be indicated for OCD?
When symptoms persist despite nonsurgical treatment
What is the likely cause of disruption to the blood supply and resulting OCD?
Repetitive trauma or stresses to the bone over time
What is a common symptom of advanced OCD cases?
Joint catching or locking
What is the typical outcome for OCD lesions in children and young teens?
They often resolve on their own with rest and nonsurgical treatment
What is the primary goal of drilling into the lesion in the treatment of osteochondritis dissecans?
To encourage healing of the surrounding bone by establishing new blood vessels
What is the purpose of crutches, splinting, or casting in nonsurgical treatment of OCD?
To reduce pain and swelling
What is the purpose of internal fixation in the treatment of osteochondritis dissecans?
To hold the lesion in place
What is the benefit of using an osteo-cartilagenous graft in the treatment of osteochondritis dissecans?
It regenerates healthy bone and cartilage in the damaged area
What is the typical size of the lesion in older teens with osteochondritis dissecans?
Greater than 1 centimeter in diameter
What is the purpose of an X-ray in the treatment of osteochondritis dissecans?
To monitor the healing process
What is the purpose of an osteotomy through the intertrochanteric region in the treatment of a hip condition?
To shorten the period of immobilization
What is the purpose of putting the hip in internal rotation and abduction in the treatment of a specific hip condition?
To contain the epiphysis within the acetabulum and prevent distortion
What is the name of the X-ray view that can show the deformity in a specific hip condition?
Frog lateral view
Which of the following is a characteristic of a patient with slipped upper femoral epiphysis?
Overweight hypogonadal boy
What is the prognosis for a younger child with a hip condition that involves only part of the head?
Good, with a low risk of complications
What is the difference in prognosis between boys and girls with a hip condition for any given age?
Girls fare worse than boys
Study Notes
Osteochondritis Dissecans (OCD)
- The exact cause of OCD is unknown, but repetitive trauma or stresses to the bone over time are probable contributing factors.
- Symptoms of OCD include pain and swelling of a joint, often triggered by sports or physical activity.
- Advanced cases of OCD can cause joint catching or locking.
- X-rays are essential for initial diagnosis and evaluating the size and location of the OCD lesion.
- Magnetic Resonance Imaging (MRI) is used to assess the extent of damage to the overlying cartilage.
- In most cases, OCD lesions in children and young teens will heal on their own with rest and avoidance of vigorous sports.
- Non-surgical treatment options include resting, avoiding sports, using crutches, splinting, or casting the affected limb for a short period.
- Most children start to feel better over a 2- to 4-month course of rest and non-surgical treatment.
Surgical Treatment
- Indications for surgery include:
- Failure of non-surgical treatment to relieve pain and swelling
- Separation or detachment of the lesion from the surrounding bone and cartilage
- Large lesions (greater than 1 centimeter in diameter), especially in older teens
- Surgical procedures include:
- Drilling into the lesion to create pathways for new blood vessels
- Internal fixation (using pins and screws) to hold the lesion in place
- Replacing the damaged area with a new piece of osteo-cartilagenous graft to regenerate healthy bone and cartilage
Slipped Upper Femoral Epiphysis
- The developing epiphysis of the hip partially slips, often in an overweight hypogonadal boy.
- Symptoms include hip pain or referred pain to the knee.
- Diagnosis may be difficult and delayed, but a 'frog lateral' X-ray can show the deformity.
- Trethowan's sign is positive in slipped femoral epiphysis.
Test your knowledge on Osteochondritis Dissecans, a joint condition that affects the blood supply and causes pain, swelling, and joint locking. Learn about the symptoms, diagnosis, and treatment of OCD.
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