Osteochondritis Dissecans and Loose Bodies of the Elbow: Pathology and Indications

Capitellar osteochondritis dissecans (OCD) is a rare, localized disease of the subchondral bone of the humeral capitellum, most commonly affecting children between 10 and 15 years old (range 10–24 years) who participate in overhead or upper extremity weight-bearing sport activities. Examples of high-risk sports are baseball, tennis, gymnastics, and weightlifting [1]. Patients are typically present with vague, insidious, activity-related lateral elbow pain [2]. Timely recognition and treatment are crucial for the prognosis. Unfortunately, diagnostic delay is common due to its specific clinical presentation and because the lesion is missed on simple radiographs in 50% of cases [3]. Therefore, low threshold for computed tomography (CT) or magnetic resonance imaging (MRI) in teenagers with lateral elbow pain will help the clinician. Osteochondritis dissecans should be differentiated from an osteochondral defect, which in general has an acute onset after a traumatic event.