Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2000;61(1):158

See related article on osteochondritis dissecans.

What is OCD?

In osteochondritis dissecans (OCD for short), a loose piece of bone and cartilage separates from the end of the bone. The loose piece may stay in place or fall into the joint space, making the joint unstable. This causes pain and feelings that the joint is “catching” or “giving way.” These loose pieces are sometimes called “joint mice.” OCD usually affects the knees and elbows.

Who gets OCD?

Anyone can get OCD, but it happens more often in boys and young men 10 to 20 years of age, while they are still growing. OCD is being diagnosed more often in girls as they become more active in sports. It affects athletes, especially gymnasts and baseball players. The adult form occurs in mature bone, and the juvenile form occurs in growing bone.

How do I know my joint pain is OCD?

If you have a sore joint (especially your knee or elbow), see your doctor. You might have swelling. You might not be able to extend your arm or leg fully. Your pain may or may not be related to an injury. You may have pain during activity and feel stiff after resting. These are all clues to your doctor that you may have OCD. Your doctor will check you to be sure the joint is stable and check for extra fluid in the joint. Your doctor will consider the possible causes of joint pain, such as fractures, sprains and OCD. If OCD is suspected, your doctor will order x-rays to check all sides of the joint.

What tests should I have?

If signs of OCD are seen on x-ray of one joint, you'll have x-rays of both joints to compare them. After this, you may have MRI (magnetic resonance imaging). MRI can show if the loose piece is still in place or if it has moved into the joint space. If the loose piece is unstable, you might need surgery to remove it or secure it. If the loose piece is stable you may not need surgery, but you may need other kinds of treatment.

Do I have to stop sports activities?

If a nonsurgical treatment is recommended, you should avoid activities that cause discomfort. You should avoid competitive sports for six to eight weeks. Your doctor may suggest stretching exercises or swimming instead.

Can OCD be cured?

Young people have the best chance of returning to their usual activity level, although they might not be able to keep playing sports with repetitive motions, such as baseball pitching. Adults are more likely to need surgery and are less likely to be completely cured. They may get arthritis in the joint later on.

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