OCD elbow

[lolo132]

Hello, I am asking on behalf of my 13 year old daughter. She is a high level competitive gymnast and was just diagnosed with OCD in the right elbow. The MRI shows a 8x8.5mmdefect on the capitellum of osteonecrosis and a displaced fragment of lent inform shape anterior in the joint. There is a small joint effusion. This is about 5 weeks of rest for the arm. She has no pain, or grip issues with day to day movement. Range of motion is full on extension and minor change on flexion. What would you recommend?  Is surgery automatic because of th loose body?  She wants to return to competitive gymnastics and we want to make the right decisions for her health and athletic future!  Any information would be greatly appreciated
Sincerely, Lori in Ontario

[Snowhao]

Hi Dr. Kaul,
My 13 year-old son, who is a very competitive swimmer and table tennis player, has also diagnosed with OCD in his right elbow started June last year. The last year December MRI told that his joint was still intact with a piece of shadow and some effusion. He has stopped playing table tennis which is considered the one that likely caused the problem but been swimming kind of 'normally', which is considered might be even 'helpful'. Right now he is able to do almost everything but still feel the pain after big load of swimming practice or after a high level swimming competition.
I think it has been long enough since his problem started last June and the proble is still there. At this point Dr. Kaul, what do you think we should do? Keep going like this regardless the pain during any sports, and wait the joint to heal by itself, or better stop all the sports completely and wait to have a higher chance to heal?
I am going to schedule another X-ray or MRI to see if the conditions are still 'stable' or hopefully better, but for now I am guessing it may be about the same.
Looking forward to your opinions.
Thank you,
Xiaodong in Michigan

[S. Kaul, MD]

Hey Lori!

Though a lower threshold is usually considered for individuals in competitive sport, surgery may or may not be recommended based on the size of the loose body and symptoms. Since there are no major movement abnormalities, the size of the loose body is likely to be small and a surgical approach may not be required, though the situation and the management plan is best discussed with her treating orthopedician/ sports medicine specialist.
Hope this is helpful.

Take care!