Osteochondritis dessicans causes pain and stiffness of the ankle joint. It can occur in all age groups. Most cases of osteochondritis dessicans usually follow a twisting of the ankle.

Anatomy

Osteochondritis dessicans occurs at the top of the talus. Most of these lesions are thought to be caused by injury to the bone underneath the joint surface by a twisting injury. Some are actual chip type fractures, while others may result from injury to the bone’s blood supply causing an area of the bone to actually die.

Symptoms

Osteochondritis dessicans can cause swelling and a generalized ache in the ankle. There may also be a “catching” sensation with the ankle in certain positions.

Diagnosis

The history and physical examination may suggest the diagnosis of osteochondritis dessicans. X-rays of the ankle usually reveal a defect on the talar dome. A CAT scan or MRI scan may be necessary to determine the full extent of the area involved.

Treatment

Treatment for osteochondritis dessicans depends on when the problem is discovered. If the problem is discovered immediately after a twisting injury to the ankle, then immobilization in a cast for 6 weeks may be suggested to see if the bone heals.

Surgery

If the problem is not associated with an acute injury, surgery may be required to try and reduce your symptoms. Surgery usually involves removing the loose fragment of cartilage and bone from the ankle joint and placing small drill holes in the defect. The drill holes stimulate new blood vessels to fill the area and help to form scar tissue to fill the defect. In some cases the surgery can be done through the arthroscope instead of through an open incision. You will probably be on crutches following surgery for at least 6 weeks.