To the Editor:
Joint pain and swelling are common symptoms of patients with juvenile idiopathic arthritis (JIA) with active joint inflammation. When patients with JIA have persistent pain or mechanical symptoms despite treatment of their inflammation, other causes must be considered.
Osteochondritis dissecans (OCD) is a focal alteration of subchondral bone formation that causes softening of the overlying cartilage, which can progress to instability, eventual osteochondral detachment, and early osteoarthritis1. Poorly localized knee pain with activity is common in early OCD lesions, and progresses to swelling, catching, or locking as the lesion becomes unstable1. The incidence in the general population is 9.5–29/100,000, occurring 2–3.8 times more frequently in males than females1,2,3. The most commonly affected joint is the knee1. Fifty-one to 69% of knee lesions affect the medial femoral condyle (MFC), and 16.5–33% affect the lateral femoral condyle (LFC)1,2,3. First-line management is conservative, with 33.5% requiring surgical intervention4. Multiple theories regarding the etiology of OCD lesions …
Address correspondence to Dr. R.A. Berard, Department of Paediatrics, 800 Commissioners Road E, London, Ontario N6A 5W9, Canada. E-mail: Roberta.berard{at}lhsc.on.ca
In this issue
