Osteochondritis dissecans (OCD) of the shoulder is a rare condition in which the subchondral (beneath the cartilage) bone is injured and causes pain. Early lesions identified by an MRI scan can heal with rest. Over time, OCD lesions can progress with loss of bone and loosening of the bone fragment and overlying cartilage. Eventually, the fragment can come loose as the unsupported cartilage cracks, leaving a hole in the smooth joint surface.
What Is Shoulder OCD?
Osteochondritis dissecans (OCD) affects the subchondral bone beneath the cartilage of the shoulder joint. Early lesions can heal with rest.
Over time, an OCD lesion can progress with resorption or loss of bone, as well as loosening of the bone fragment and overlying cartilage. Eventually, the fragment can come loose as the unsupported overlying cartilage cracks, leaving a hole in the smooth joint surface.
Causes and Risk Factors
Causes and risk factors for shoulder OCD include:
- Repetitive motion and overuse
- Possible compressive, shearing, or rotational force to the shoulder
- Overuse activity involving repetitive motion of the shoulder
- Poor flexibility and physical conditioning
Symptoms
Signs and symptoms may include:
- Pain and swelling
- A feeling of something moving in the joint
- The joint “giving way,” catching, or locking
- Pain that increases with activity
Treatment
If the OCD lesion appears stable, younger patients are likely to be treated conservatively with a sling or limited activities.
If the OCD is unstable or fails to heal with conservative treatment, Dr. Chudik can perform arthroscopic surgery to address the lesion. The surgical method is determined by the size and instability of the bone and cartilage involved.
Small unstable fragments can be removed, and the surface of the bone can be stimulated to promote a healing response. Large unstable fragments can be repaired to the bone surface using fixation and bone grafting techniques.
Recovery and Outcomes
In younger patients, the chances are higher that the OCD will heal on its own as long as the patient rests, stops activity, and avoids further aggravation. Older children and young adults may need more intervention to restore joint health. Treatment can range from immobilizing the arm in a sling to surgery.
Recovery from OCD can be a lengthy process. In some cases, it may take up to 18 months to reach full healing.
When to See Dr. Chudik
Consider an evaluation for shoulder pain and swelling, pain that increases with activity, a feeling of something moving in the joint, or symptoms such as giving way, catching, or locking.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.