WAG Elbow OCD

[Stellar]

I wanted to give an update on DD's elbow. She had her MRI on Wednesday and I talked to the Dr yesterday. At first all they saw was bruising near her trochlea which is on the other side of the capitellum. Then I pushed the Dr to look again and they saw a small potential lesion (again not near the side where OCD usually occurs). The dr. consulted with the radiologists a few more times and agreed the lesion was a small stable (I think type 1) OCD lesion. The MRI showed no fracture. or displaced bone, or bone fragments. at this point they don't think surgery is necessary.

They put her on 6 weeks rest, and another MRI in 8 weeks. If surgery is necessary then, it would be marrow stimulation which involves making small holes in the lesion to promote healing.

DD is handling the news fairly well. If all goes well she will be able to train by beginning of summer. I am hopefull we caught it early and it will heal on it's own.

I've attached links to 2 articles that I found helpfull. I read these before I talked to the Dr and I was able to ask the right questions to have them look again at the results of MRI.

http://www.sportsmed.org/uploadedFi...ritis Dissecans Team Physician NovDec2012.pdf

http://usagym.org/docs/Education/library/2012_may_6.pdf

 

[LizzieLac]

Just wanted to share that we have a girl on our team that had ankle OCD. She did require the surgery, but the recovery is going really really well and the doctors believe she will have no ongoing issues.

Good luck to your DD and hoping for speedy recovery!

 

[Stellar]

Thanks LizziLac!

What makes me nervous is that it seems surgery seems to be the most successfull route, however Dr. doesn't think it's necessary at this point. I guess since they didn't even see the lesion at first, it must small and at early stages. I certainly don't want DD to undergo surgery if she doesn't need it, but are we she prolonging the inevitable??

 

[bookworm]

I think that surgery is the most successful route, especially for a high level gymnast...it's the repetitions that lead to the OCD and historically, the gymnast can never rest "enough" to make that route work...not saying you can't try but go into it with your eyes wide open to the possibility of surgery.

 

[Stellar]

I kow that surgery is the most successful, but doctor wants to try this route. Maybe I need to have another dr look at her scans. Again I don't want to push her into surgery, but if she needs it then why not get it done now.

 

[Deleted member D3987]

you don't rush in to it because they heal on their own most of the time. when they don't, they drill a few holes and out the door you go. recovery is pretty quick. just an unfortunate consequence of sports.

 

[LizzieLac]

Thanks LizziLac!

What makes me nervous is that it seems surgery seems to be the most successfull route, however Dr. doesn't think it's necessary at this point. I guess since they didn't even see the lesion at first, it must small and at early stages. I certainly don't want DD to undergo surgery if she doesn't need it, but are we she prolonging the inevitable??

Just so you have all of the information, doctors did at first think that she didn't need surgery. They had her completely non-weight bearing for a couple of months. She then tried to practice but still had pain. Mother actually sent MRIs to USAG doctors for consult. Net-net was the surgery. But as I said the recovery has been great. Prognosis is excellent and she is supposed to be back in the gym by June.

 

[Stellar]

I was thinking of sending the MRIs to a couple more dr for consults too. Do you happen to know what dr she sent them to?

 

[LizzieLac]

Sent you a PM.

 

[Deleted member D3987]

I was thinking of sending the MRIs to a couple more dr for consults too. Do you happen to know what dr she sent them to?

Dr. Larry Nasser

 

[3rd_time_around]

you don't rush in to it because they heal on their own most of the time. when they don't, they drill a few holes and out the door you go. recovery is pretty quick. just an unfortunate consequence of sports.

This is the surgery my dd was told she would need. And actually, it's not a few holes and out the door, especially in the elbow. After the MRI, my dd was told it would be 3 months of nothing, not even lifting a pencil, then therapy before getting back in the gym. We got a 2nd opinion because I felt this was such an invasive surgery and serious thing that i needed a 2nd opinion. The 2nd opinion was the same as the first. But, when they went in, they removed the piece of broken off bone, and decided against the microfractures to patch the bone, because of the placement of the void on the arm bone. Thank goodness. I hope, OP, that your dd doesn't need the surgery.

 

[Deleted member D3987]

i was speaking about just normal OCD. it really is quite simple and recovery very short. GAgymmom's daughter was more involved.

 

[Stellar]

Another quick (and somewhat positive update) on DD elbow. I sent sent her MRI and Xray (from Janaury) to another doctor for consulatation. And also I sent the diagnosis part of her MRI results to an elbow specialist. Both doctors got back to me yesterday and had very similar opinions.

They said her injury appears more trama related and is more of a bruise/ trochlea edema. There is a osteochonral lesion on her trochlea but does not appear to be osterchondritis dissecans which is typically on the other side of elbow. Neither think surgery is needed.

One mentioned hyperbaric oxygen treatment, but I need to find out more about this. Either way she is still resting for 6 weeks and follow up at 2 month point, but I feel very hopefull this will heal on it's own and she can start back training early summer!

 

[tomtnt]

Hi Stellar, I am a Radiologist who also has a 10-yr old level 8 daughter. She also had elbow pain so we got her an MRI. The findings are remarkably similar to what you described - high signal involving the trochlea. I looked at the MRI personally and also showed the MRI to 3 of my colleagues who specializes in sports related MRI - no one could find an osteochondral lesion. They were actually more worried about an impending stress fracture than an OCD lesion. She competed the rest of this season without much discomfort and has regional in 2 weeks.

The OCD which typically affects gymnasts is OCD of the capitellum - the part of the humerus which articulates with the radial head. We had 2 young gymnasts at our gym who had the same condition requiring surgery. One has since retired from gymnastics while the other has made a full recovery and competing level 10 again.

I am highly vigilant for any signs of possible elbow injury and plan on redoing the MRI after my daughter competes regional in 2 weeks. We'll then take off 4-6 weeks to let the marrow edema in her trochlea heal.

Good luck to your daughter and keep us updated on her recovery.

 

[Stellar]

Hi tomtnt,

it is interesting how similar your daughters elbow injury is. I hope everything looks OK on her MRI and that she has an easy recovery!

Good luck to her at regionals!