Bilateral osteochondral defects of the patellae in an 11-year-old girl

BMJ Case Rep. 2021 Apr 23;14(4):e240790. doi: 10.1136/bcr-2020-240790.

Abstract

Osteochondral defect or osteochondritis dissecans (OCD) of the knee usually affects young, active populations. It is a challenging diagnosis as patients typically present with poorly localised activity-related pain, which is non-specific and covers many differentials. We present an active 11-year-old girl with bilateral osteochondral defects of the patellae: a rare clinical disorder which was affecting her sporting activities. She had a 12-month history of bilateral anterior knee pain before the diagnosis was achieved with appropriate imaging. Her pain significantly improved with activity modification and physiotherapy. Follow-up will require outpatient clinic assessment and imaging to determine if non-operative management continues to be successful or surgery may be required. This case report emphasises the importance of appropriate high index of suspicion when managing patients with non-specific knee pain. It also demonstrates the importance of judicious use of imaging to avoid a missed or delayed diagnosis.

Keywords: orthopaedic and trauma surgery; patellofemoral pain; sports and exercise medicine.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Female
  • Humans
  • Intra-Articular Fractures*
  • Knee
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery
  • Osteochondritis Dissecans* / diagnostic imaging
  • Osteochondritis Dissecans* / therapy
  • Patella