What Is Osteochondritis Dissecans?

Otochondritis, costal chondritis, and exfoliative osteochondritis (OCD) are common, and recurrent polychondritis is rare.

Otochondritis, costal chondritis, and exfoliative osteochondritis (OCD) are common, and recurrent polychondritis is rare.

Chinese name

Chondritis

Foreign name

chondritis

Chondritis I. Causes and common diseases:

(A) ear chondritis:

External ear burns can be accompanied by ear cartilage inflammation. The occurrence of osteochondritis is related to local dampness, compression and infection.

(2) Costal chondritis:

The etiology of costal chondritis is not clear. Many patients have a history of viral upper respiratory tract infection before the onset of the disease. Therefore, the occurrence of this disease may be related to viral infection, or it may be caused by chronic strain of the thoracocostal joint ligament, various cost Cartilage dystrophy is related to tuberculosis, systemic malnutrition, acute bacterial upper respiratory tract infections, rheumatoid arthritis, subdislocation of the thoracocostal joint, and injuries caused by chest impact injuries and severe cough.

(Three) exfoliative osteochondritis:

The cause of OCD is partly caused by external trauma, but most patients have no history of trauma, so the pathogenesis is not clear. Studies have suggested that it may be related to genetics, endocrine, ischemia, trauma and other factors.

(4) Recurrent polychondritis:

Relapsing polychondritis (RP) is a relatively rare autoimmune disease. The disease can affect cartilage in many organs, including ears, nose, throat, joints, rib cartilage, and bronchi. It can also affect the inner ear, heart, Skin and aorta, which are rich in mucin, are a serious threat to the life and health of patients.

Chondritis II. Differential diagnosis:

(A) ear chondritis:

Ear chondritis is severely painful, the ears are red and swollen, and then become abscesses, ulcers and pus. The necrotic ear cartilage is not cleared, and it is difficult to heal.

(2) Costal chondritis:

The initial manifestation of non-specific costal chondritis is local pain in the chest wall. After a few days, swelling and swelling appear in the lesion, deep breathing, coughing, chest lift and other activities, and the pain worsens after fatigue. Some people have a more rapid onset and may feel tingling, bouncing or soreness in the chest; others have a slow onset, and unknowingly feel swelling at the junction of the sternum and rib cartilage with arch-like pain. Costal chondritis has varying degrees of pain, is easy to repeat, and varies in duration. It can heal for months or years.

(Three) exfoliative osteochondritis:

1. Ischemic necrosis of the bone is common in the elderly over the age of 60, and there is a history of typical fractures after trauma, a history of hormone therapy or a history of alcohol abuse.

2. Knee joint degenerative osteoarthritis: exfoliative osteochondritis grade and early chondromalacia are not easy to distinguish, grades to are easier to distinguish due to characteristic MRI manifestations and degenerative changes, and joint degeneration can be seen on the edge of the bone Bone hyperplasia, osteophyte formation, narrowing of the knee joint space, osteosclerosis of the articular surface, etc.

3. Joint tuberculosis: The image shows osteolytic bone destruction, narrowing of joint space, formation of dead bone and abscess, and it is not difficult to identify the clinical symptoms of tuberculosis and positive tuberculin test.

4. Avulsion fracture: There is a clear history of trauma, which often occurs at the ligament attachment point. The density of avulsion bone fragments is the same as that of normal bone, and the edges are clear and sharp.

(4) Recurrent polychondritis:

According to relevant domestic literature reports, 14% to 38% of RP patients have symptoms of respiratory involvement when they seek medical treatment, and 48% to 67% of patients with respiratory involvement during the entire onset of disease, many patients often cause tracheobronchial tube wall Collapse, resulting in the occurrence of adverse symptoms such as shortness of breath, chest tightness and dyspnea.

Chondritis III. Examination:

Magnetic resonance imaging (MRI) examination:

MRI examination has good tissue resolution, which can clearly display the bone and bone marrow, cartilage, ligament, meniscus, synovial membrane, bursa, muscle and other tissue structures. Multi-parameter and multi-directional imaging can be used to display lesions and evaluate the degree of damage. It has high diagnostic value, provides an important basis for early clinical qualitative diagnosis, and is the preferred test.

Chondritis IV. Principles of treatment:

(A) ear chondritis:

After external ear burns, the wound must be kept dry and the exudate should be wiped off at any time. External application of silver sulfadiazine suspension or iodine with ointment, and hot air treatment to prevent ear chondritis. If you have osteochondritis, in addition to the above treatment, inject sensitive antibiotics at the root of the ear. If an abscess or dead bone has formed, surgical drainage should be performed as soon as possible to remove necrotic cartilage.

(2) Costal chondritis:

Costal chondritis generally does not require treatment and can heal on its own, but it still needs attention to avoid the above factors that aggravate pain symptoms. No matter what the symptoms are, you need to go to the hospital for treatment, and you must not diagnose or take medicine by yourself.

(Three) exfoliative osteochondritis:

Arthroscopic surgery is less invasive, and has advantages in direct evaluation of OCD and necessary surgical treatment of OCD through microscopic surgery.

(4) Recurrent polychondritis:

Nowadays, methylprednisolone is mainly used for clinical treatment, but it is often difficult to completely control the progress of the disease, especially when the inflammation has affected the respiratory tract and it is difficult to alleviate the dyspnea, tracheostomy and stent implantation are required immediately. Inflicted severe pain on patients, and also increased the financial burden on patients.