Osteochondritis dissecans of the humeral trochlea in two pediatric athletes: two cases and review of literature
Main Article Content
Abstract
We herein report two unusual cases of osteochondritis dissecans (OCD) of the trochlea. The injury consisted of a focal alteration of subchondral bone secondary to repetitive micro trauma from overhead maneuvers (pitching) in two male adolescents. Only 23 other cases of OCD affecting the trochlea have been reported. We comment on this discrepancy, explore the radiographic features, and detail the non-operative management that was undertaken. We substantiate our report with a systematic review of all OCD cases of the trochlea and provide information on patient demographics, sport type, management, recuperation and finally significance of radiographic grading.
Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Patel N, Weiner SD. Osteochondritis dissecans involving the trochlea: report of two patients (three elbows) and review of the literature. J Pediatr Orthop. 2002;22(1):48-51.
Stubbs MJ, Field LD, Savoie FH, 3rd. Osteochondritis dissecans of the elbow. Clin Sports Med. 2001;20(1):1-9.
Yamaguchi K, Sweet FA, Bindra R, Morrey BF, Gelberman RH. The extraosseous and intraosseous arterial anatomy of the adult elbow. J Bone Joint Surg Am. 1997;79(11):1653-62.
Pappas AM. Osteochondrosis dissecans. Clin Orthop Relat Res. 1981(158):59-69.
Pruthi S, Parnell SE, Thapa MM. Pseudointercondylar notch sign: manifestation of osteochondritis dissecans of the trochlea. Pediatr Radiol. 2009;39(2):180-3.
Woodward AH, Bianco AJ, Jr. Osteochondritis dissecans of the elbow. Clin Orthop Relat Res. 1975(110):35-41.
Burr RC. Osteochondritis Dissecans. Can Med Assoc J. 1939;41(3):232-5.
Chen NC. Osteochondritis dissecans of the elbow. J Hand Surg Am. 2010;35(7):1188-9.
Iwsaki N, Yamane S, Ishikawa J, Majima T, Minami A. Osteochondritis dissecans involving the trochlea of the humerus treated with transplantation of tissue-engineered cartilage: a case report. J Shoulder Elbow Surg. 2008;17(5):e22-5.
Jans LB, Jaremko JL, Ditchfield M, Huysse WC, Verstraete KL. MRI differentiates femoral condylar ossification evolution from osteochondritis dissecans. A new sign. Eur Radiol. 2011;21(6):1170-9.
Joji S, Murakami T, Murao T. Osteochondritis dissecans developing in the trochlea humeri: a case report. J Shoulder Elbow Surg. 2001;10(3):295-7.
Marshall KW, Marshall DL, Busch MT, Williams JP. Osteochondral lesions of the humeral trochlea in the young athlete. Skeletal Radiol. 2009;38(5):479-91.
Namba J, Shimada K, Akita S. Osteochondritis dissecans of the humeral trochlea with cubitus varus deformity. A case report. Acta Orthop Belg. 2009;75(2):265-9.
Vanthournout I, Rudelli A, Valenti P, Montagne JP. Osteochondritis dissecans of the trochlea of the humerus. Pediatr Radiol. 1991;21(8):600-1.
E ZM, Kontulainen S, Baxter-Jones ADG, Whiting S, Szafron M, Papadimitropoulos M, et al. Are milk and alternatives and fruit and vegetable intakes during adolescence associated with cortical and trabecular bone structure, density, and strength in adulthood? Osteoporos Int. 2017;28(2):609-19.
Edmonds EW, Polousky J. A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from Konig to the ROCK study group. Clin Orthop Relat Res. 2013;471(4):1118-26.
Jin-Ho L, Myung-Sun K. Osteochondritis Dissecans in Medial Trochlea of the Humerus in a Pitcher: A Case Report. Clinics in Shoulder and Elbow 2014; 17(1):40-43. doi:10.5397/cise.2014.17.1.40
Miyake J, Kawabata H, Takeuchi M. Rapid growth of supracondylar process: a case report. J Pediatr Orthop B. 2013 Mar;22(2):141-3. doi: 10.1097/BPB.0b013e32835368d9.