Q: I am 14 and twisted my right ankle playing soccer. I had X-rays in the emergency room and was told that I had a sprain and that nothing was broken. However, my ankle stayed sore and has only gotten a little better in the last two months. Last week I saw a sports medicine doctor who diagnosed a condition called osteochondritis dissecans. He said that this would need surgery and was the source of my ankle pain. I did not understand what was going on and wanted your opinion.

A: Osteochondritis dissecans is a condition where the microcirculation to a small part of the bone and cartilage in a joint is compromised. This can occur in any joint but most commonly the knee, the ankle and the elbow. If the small piece of bone and cartilage are still in place and your growth plates are still open, there is a chance that this could heal nonsurgically with rest or cast immobilization.

However, if the bony fragment has started to come loose or you are at an age where this is less likely to heal, then surgery may be indicated. In addition to the X-rays, an MRI scan or CT scan may also be helpful in making a surgical decision.

If you are still unsure as to what your orthopedic surgeon was telling you, you may want to seek a second opinion.

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