Osteochondritis dissecans of the elbow
Causes / typical injury mechanism:
- OCD of the elbow can occur in all sports, but it is most common in baseball and gymnastics.
- Baseball – Occurs in the dominant arm due to the repetitive valgus load across the elbow during throwing.
- Gymnastics – Continuous impact can lead to trauma across the elbow. The few cases in which bilateral disease was identified were found in gymnasts.
- The capitellum is the most common aspect of the elbow to be involved, with a negligible amount of cases reported in the trochlea, radial head, or olecranon.
- OCD is also commonly found in the knee and ankle.
Prevalence: Overall, prevalence has been cited as ranging from 1%-3%.
- Age – OCD of the elbow typically occurs in patients aged 6-20 years, and the most common age group is patients aged 12-19 years (about 12 times more likely compared to patients aged 6-11 years).
- Sex / gender – OCD of the elbow is most commonly found in non-Hispanic White males.
- Repetitive valgus load across elbow.
- Continuous weight-bearing impact across the elbow.
- "Mismatch" between the softer lateral capitellum and firmer radial head, leading to microtrauma to the capitellum from repetitive loading or overuse. Medial laxity can develop in overhand throwers, allowing for increased force across the radiocapitellar joint in valgus movements seen in throwing and with axial loading in gymnastics.
- Immature capitellum supplied by end arteries without much anastomosis with the metpahysis results in ischemia and leads to breakdown of subchondral bone.
- As the process progresses and worsens, the articular cartilage can fissure, flap, or even detach completely, resulting in intra-articular loose bodies.
M93.229 – Osteochondritis dissecans, unspecified elbow
315161000119104 – Osteochondritis dissecans of left elbow
315221000119100 – Osteochondritis dissecans of right elbow