Bone Chips in the Elbow (Osteochondritis Dissecans)

What are bone chips in the elbow?

Bone chips in the elbow are small pieces of bone or cartilage that have come loose and float around in the elbow joint. The pieces of bone and cartilage usually come from the upper arm bone. (Cartilage is tough, smooth tissue that lines and cushions the surface of the joints.)

The medical term for this condition is osteochondritis dissecans of the elbow. Sometimes the chips are called loose bodies.

What is the cause?

The chips usually result from an injury to the elbow or from a lack of blood supply to the bone. Gymnasts and athletes whose sport involves a lot of throwing may also get bone chips in the elbow.

What are the symptoms?

Symptoms may include:

• Your elbow hurts when you move it and sometimes it may lock in place.
• You may hear a clicking sound when you move your elbow.
• You may feel something inside the joint.
• Your elbow may be swollen and you may not be able to completely straighten your arm.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, review your medical history, and examine your elbow. Tests you may have include:

• X-ray
• magnetic resonance imaging (MRI), which uses a powerful magnetic field and radio waves to take pictures from different angles to show thin cross sections of the body

How is it treated?

You will need to rest your elbow and avoid sports and activities that cause pain until the symptoms are gone. To lessen swelling and pain in the first day or two, your healthcare provider will probably tell you to:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth, on the painful area every 3 to 4 hours for up to 20 minutes at a time.
• Take an anti-inflammatory medicine, such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

Sometimes surgery is needed to remove large fragments and repair the joint surface. Small bone chips or cartilage fragments that don’t affect elbow motion and don’t get painful again may not need to be removed.

How can I take care of myself?

• Follow your treatment plan.
• Rest your elbow until the pain goes away. This may take up to a few weeks.
• Keep all appointments for provider visits or tests.
• Contact your healthcare provider if you have new or worsening symptoms.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your elbow recovers, not by how many days or weeks it has been since your elbow started bothering you. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is for you to be able to get back to your normal activities as soon as is safely possible. If you do this too soon you may worsen your injury.

You may go back to your activities when:

• You can forcefully grip things, such as a bat or golf club, or do activities such as working at a keyboard, without pain in your elbow.
• You don’t have any swelling around your elbow and it is as strong as your other elbow.
• Your injured elbow is as strong as your other elbow.
• You have full range of motion of your elbow.

How can I help prevent bone chips in the elbow?

Bone chips are usually caused by injuries to the elbow that are not easily prevented.