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“Give always the best of yourself, even when nobody looks!”

Adriana Reis Souza, artist.

Osteochondritis Dissecans

This entity is to be viewed completely separated from other ones in the musculoskeletal system.

It has to do with osteonecrosis, but unlike the one of the femoral head in the hip, not due to intra-articular overpressure.

Frequently occupying articular periphery, it involves cartilage and sub-chondral bone as well.

We call it mouse in the mouse bed, when still at its place.

Most often encountered in the knee, it can be observed also occasionally in the ankle.

Rare in the superior extremity, it has to do with long arterial paths, which points to its etiology.

Thus, arteriopathy of any origin can be the trigger.

Most frequently, of course it is atherosclerosis.

Hypercoagulability due to a deficit of vitamin B12 deposits clots at arterial ends.

Sub-endothelial atheroma is first released from vessel wall.

A minute lesion of endothelial surface plays a central role.

Dental plaques germs are involved, but they act on surface of cell fragility, due to a deficit in Omega’s acids, 3, 6 and 9 mainly.   

When viewed as mouse in the mouse bed you can try playing on triggering factors to reverse the processus, but when outside, you need the orthopedic surgeon.

For the situation when the fragment is still in place, a dedicated mesh or a grid needs to be invented.

This is quite a possibility, as the location is frequently at articular periphery, where fixing with small screws can be justified.