Knee Osteochondritis Dissecans Clinical Presentation

Updated: Sep 16, 2022
  • Author: Brian A Jacobs, MD, FACSM; Chief Editor: Craig C Young, MD  more...
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Symptoms are usually vague and poorly localized. A vague ache within the knee, with possible clicking or popping, may be reported. Varying degrees of pain, swelling, and stiffness are reported.

Symptoms may be associated with activities (eg, sports, activities of daily living).

With complete fragment separation, locking symptoms may occur.

Prolonged symptoms lead to progressive degenerative arthritis.

Giving way of the knee may occur secondary to quadriceps weakness.


Physical Examination

Effusion may be present.

Quadriceps atrophy and weakness may be evident.

Occasionally, a loose body may be palpable.

The patient may lack full knee extension compared with the contralateral knee.

Tenderness is noted over the lesion.

Evaluate gait for external rotation of the tibia.

Perform the Wilson test to check for OCD. The examiner flexes the knee to 90° while internally rotating the tibia. A positive Wilson sign occurs when pain is elicited at 30° of flexion and is relieved with external rotation.