Intended for healthcare professionals

Endgames Spot Diagnosis

Knee pain in an athletic young man

BMJ 2018; 362 doi: (Published 13 September 2018) Cite this as: BMJ 2018;362:k3355
  1. Charlotte Marriott, clinical teaching fellow1,
  2. Christopher George, consultant radiologist2
  1. 1St Helier Hospital, Sutton, UK
  2. 2Epsom General Hospital, Epsom, UK
  1. Correspondence to C Marriott c.marriott2{at}

An athletic 22 year old man presented with swelling and locking of the left knee, and underwent plain radiography (fig 1). He had not experienced any recent trauma but had received several football injuries as a child. Two years before this presentation, he underwent plain radiography and magnetic resonance imaging (MRI) for disabling knee pain, and was diagnosed with osteochondritis dissecans (OCD) (fig 2). What abnormality is shown in fig 1?

Fig 1

Plain radiograph showing a lateral view of the left knee (current presentation)

Fig 2

Plain radiograph showing a lateral view of the left knee (two years previously)


Displaced osteochondral body (a dislodged fragment of subchondral bone), resulting from OCD.

OCD is the separation of a segment of …

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