Houston Methodist. Leading Medicine

Elbow FAQ

Question:

My 13-year old son was just diagnosed with OCD of the elbow. What is the prognosis for this kind of problem? I don't know much about what happens to young kids with this condition.

Answer:

OCD stands for osteochondritis dissecans. It is a lesion of the bone under the joint that also affects the joint surface. Forceful and repeated actions of the elbow in a young teenager can strain the immature surface of the outer part of the elbow joint. The bone under the joint surface weakens and becomes injured, which damages the blood vessels going to the bone. Without blood flow, the small section of bone dies. The injured bone cracks. It may actually break off. The result is this condition known as osteochondritis dissecans (OCD). In the past, this condition was called Little Leaguer's elbow. It got its name because it was so common in baseball pitchers between the ages of 12 and 20. Now it is known that other sports, primarily gymnastics and racket sports, put similar forces on the elbow. These sports can also lead to elbow OCD in adolescent athletes. The prognosis is somewhat guarded. Early diagnosis and treatment can help. But even with proper care, some patients end up with permanent disability of the elbow and joint osteoarthritis. A stiff and painful elbow can make activities of daily living difficult. Current methods of treatment aren't always able to restore the joint's ability to handle the shearing and compressive forces and load placed on the joint(s) of active athletes. Conservative (nonoperative) care may involve an extended time of rest and recovery without participation in sports or activities. Getting back to the athlete's previous level of play can also be a problem. Some doctors have their patients work with a physical therapist. Treatments such as heat, ice, and ultrasound may be used to ease pain and swelling. Therapists also work with young athletes to help them improve their form and reduce strain on the elbow during sports. When the elbow starts to feel better, exercises are begun to get the elbow moving. At first, the movements are done passively, meaning that the therapist moves the arm. This is followed with active motion exercise, which means the patient's muscles help do the work of moving the arm. As elbow motion and strength improve, patients progress in more advanced strengthening exercises. If pain relief is not obtained with sufficient conservative care, then surgery may be needed. Most patients will need to modify their activities after surgery. In general, most athletes with elbow OCD need to stop playing high-level sports due to lingering elbow pain and reduced elbow motion. If symptoms come back again, patients must modify their activities until symptoms subside. They'll need to avoid heavy sports activity until symptoms go away and they are able to safely begin exercising the elbow again. Kohei Nishitani, MD, et al. Intraoperative Acoustic Evaluation of Living Human Cartilage of the Elbow and Knee During Mosaicplasty for Osteochondritis Dissecans of the Elbow. An In Vivo Study. In The American Journal of Sports Medicine. December 2008. Vol. 36. No. 12. Pp. 2345-2353.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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