• Benign noninflammatory condition affecting young adults, with necrosis of subchondral bone and adjacent articular cartilage causing separation from adjacent structures
• Subchondral bone may remain attached to joint surface / synovium
  • If attached, both bone and cartilage remain viable
  • If detached, bone dies but cartilage remains viable through synovial fluid nutrients
• Probably due to trauma, although familial autosomal dominant (Clin Orthop Relat Res 1979;(140):131) and bilateral symmetric cases have been described
• Symptoms include joint pain, joint effusions, locking of joint

• Usually at lateral aspect of medial femoral condyle near intercondylar notch; also ankle and elbow joints

• Well demarcated defect in articular surface of joint

• 14 year old with pain, swelling and inability to move right knee joint (J Orthopaedic Case Reports 2012;2:3)
• 26 year old housewife with chronic ankle pain (BMJ Case Rep 2009;2009 Epub 2009 Apr 14)

• Reattachment (if possible) or excision

• Flat, smooth nodule of avascular bone with overlying articular cartilage
• Layer of fibrocartilage is usually present on bony surface

Head of femur

Osteochondritis of left humeral head with secondary deformation of bone, eighth to ninth century from Iona

• Articular cartilage, often with calcification; 50% have subchondral bone

Pathological specimen of Danish sow

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