Osteochondritis Dissecans (Bone Chips) of the Elbow

What is osteochondritis dissecans of the elbow?

Osteochondritis dissecans of the elbow is a disorder in which fragments of bone or cartilage come loose and float around in the elbow joint. Cartilage is tough, smooth tissue that lines and cushions the surface of the joints. These chips usually come from the upper arm bone (humerus).

How does it occur?

The chips usually result from a forceful injury to the elbow joint. It is also seen in the elbows of throwing athletes and gymnasts.

What are the symptoms?

It hurts when you move your elbow. Your elbow may click or lock or you may feel a bone chip inside the joint. Your elbow may be swollen and you may not be able to completely straighten your arm.

How is it diagnosed?

Your health care provider will review your symptoms and examine your elbow. He or she may do an x-ray, which may show a bone chip or an abnormal joint surface. Your provider may order an MRI.

How is it treated?

The initial treatment for osteochondritis dissecans is to rest your elbow until the symptoms are gone. This may take up to a few weeks. You should apply ice to the elbow for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain and swelling go away. Your health care provider may prescribe an anti-inflammatory medication or other pain medication. Small bone chips or cartilage fragments that do not affect elbow motion and do not cause further pain do not need to be removed. Surgery may be needed to remove larger fragments and to repair the injured joint surface.

When can I return to my sport or activity?

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your elbow recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may return to your sport or activity when your are able to forcefully grip your tennis racquet, bat, or golf club, or do activities such as working at a keyboard without pain at your elbow. In sports such as gymnastics, you should be able to bear weight on your elbow painlessly. There should be no swelling around your injured elbow and it should have regained its normal strength compared to your uninjured elbow. You must have full range of motion of your elbow.

How can I prevent osteochondritis dissecans of the elbow?

Osteochondritis dissecans is usually caused by trauma to the elbow and is not preventable.