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Grinding noises in elbow and knee. Cartilage degradation?

Hello!

I am a 27 year old man who have been lifting weights for several years. I have been lifting heavy and pushing my limits, but never so heavy that I couldn't do at least 10 reps over 3 sets for each exercise.

However, one year ago I suddenly felt a sharp pain in my left elbow while doing overhead dumbbell press. My elbow also locked up for a bit. After this the elbow felt stiff and uncomfortable, but the most noticeable change was the fairly loud grinding noise that came whenever i moved my elbow. Over the past year I have been to several doctors and I was completely cutting out the weight lifting. I took an x-ray and an MR scan of the elbow, but the doctors couldn't find anything. They all could hear the noise and I told them about the stiffness, pain and lockings, but there was no answer to get. The last orthopedic physician I spoke to told me that it didn't matter and I should keep on lifting. I don't feel completely confident in his advice as he did not really tell me what was wrong with the elbow.

As I haven't been lifting weights for 13 months now, I don't have any pain or lockings anymore, but the grinding noise is still there, even if I only lift a pencil.

- I generally don't have any pain or stiffness in the elbow exept for the incident described above.
- No swellings.
- No pain when pushing on the joint.
- There are some minor movement restrictions in the elbow.

I also have a really bad grinding noise in my left knee, and occasionally I will feel pain and stiffness after physical activity.

- Is this a symptom of cartilage degradation?
- Is this early symptoms of elbow arthisis/osteoarthritis?
- Will this get worse by starting weight lifting again?
- Is this reversible?

All answeres are greatly appreciated! Thank you!
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replied May 23rd, 2014
suggest you see someone who specialty is sports medicine. if that md can not help you, certainly should be able to refer to someone who can.
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replied June 30th, 2014
After some research I think I have figured out what this problem is. In case anyone have a similar condition here is what I have found:

The condition is called osteochondritis dissecans (OCD), and is caused by the loss of blood supply to part of the cartilage in the elbow joint. This might cause the affected part of the cartilage to die and loosen. The exact reason for this to happen is unknown in most cases. But the condition is most commonly seen in adolescent athletes, predominately affecting gymnasts, weightlifters and baseball pitchers. This makes sense since I have also experienced ulnar nerve entrapment in the elbow a couple of years ago, which caused numbness in my little and ring fingers. If the nerve has been exposed to some for of preassure, it is possible that this may have happened to the blood supply to the cartilage. Repetitive microtrauma from overuse is commmonly accepted as the etiology. Most people are unaware of any cartilage injury until pain or loss of mobility occurs. In my case I experienced pain, discomfort, lockings while lifting, reduced range of movement, crepitus (grinding noises), and some minor swelling in the elbow.

Symptoms of OCD are:

- Pain, especially when fully bending or straightening the elbow
- Elbow catching and locking when bending
- A popping or cracking noise with elbow movement (crepitus)
- Swelling in the elbow
- Tenderness at the elbow when moving it
- Difficulty moving the elbow
- Reduced range of motion in the elbow

OCD is diagnosed through the use of x-ray or MRI. I had both x-ray and MRI examination, but no abnormalities were observed. I believe this is because I had the examination before any injury to the bone had taken place.

Left untreated the contidion can lead to osteoarthritis, joint incongruity and abnormal wear patterns.
Common treatments of OCD are:

Resting the elbow
Physical therapy
Splint or brace
Cortisone injection
Surgery

There is evidence to suggest that OCD in its early stages has the capacity to heal without surgical intervention, with limits on activity, non-steriodal anti-inflamatory medication, and therapy to improve range of motion. Patients that are treated without surgery should be monitored closely with consideration for surgical intervention if patients do not improve after six months.

This far I have rested my elbow for about 18 months. Most of the symptoms have disappeared, but the creptius and some reduced range of movement are still present. I believe the condition would worsen should I continue lifting weights.

For patients with persistent pain or unstable lesions, multiple surgical treatment options are available: joint debridement, abrasion chondroplasty, removal of loose bodies, excision of lesion with and without drilling, closed-wedge osteotomy of the capitellum, fragment fixation or replacement of articular cartilage with OATS. Timing of surgical intervention and which surgical procedure to take remains unclear.

The most frequently used technique for a capitellar lesion is debridement of the joint, removal of loose bodies if present, and drilling of the subchondral bone to promote vascularization and healing. Removing of loose bodies, with or without drilling, may increase range of motion and relieve pain, but long term functions may be compromised.

In cases of an unstable lesion, the cartilage and bone may be stabalized with use of a screw, dynamic staples, pull-out wiring and grafting with bone pegs in older patients.

Even with all these treatment options, there is little information available to suggest which is the preferred method of treatment, and there is no consensus on the long term prognosis following surgical intervention, with regards to return to sport activities or risk of arthritis and pain later in life.
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