Osteochondritis dissecans

Osteochondritis Dissecans is a frequent, but little known complaint. It is not normally diagnosed, since it used to be recognized only by surgery or autopsy, while today an MRI scan is used for diagnosis.

In essence it is a cartilage injury to the surface of the heel bone, usually beneath the outer ankle. Frequently the bone beneath the surface of the joint is cracked.

A diagnosis should be considered if ankle pain is persistent and particularly if an injury appears in the patient's case history. X-ray may show the talus being pressed in, but an MRI scan provides the true evidence.

Treatment: Treatment of this condition is dependent on the extent of the injury and the patient's complaints. In acute cases a plaster cast will be required.

If surgery is to be undertaken, the operation removes the damaged cartilage, then the bone below is drilled to enable new cartilage to form on the bone. Surgical intervention may be considered in cases that do not respond to conservative treatment.

A Pedikom restorative orthotic may be used to provide stability, rather than correction of the condition. The talus is supported by the orthotic, since it is important to support the heel against pronation.