Dear Dr. Donohue: My son, 14 and a hockey player, had complained of a sore knee that I ignored for quite some time. Finally I took him to the doctor. The doctor said he has “joint mice” and a condition called osteochondritis dissecans. What does this mean? Are they related? What’s the treatment? — C.B.
Dear C.B.: “Joint mice” are pieces of bone that have broken off the end of a bone and scurry around inside a joint.
Osteochondritis dissecans is the major cause of joint mice in youngsters. It’s death of a small piece of bone, most often due to trauma or overuse. The bit of dead bone separates from the main bone and falls into the joint. The two conditions are closely related.
The knee is the site of trouble 75 percent of the time.
Vague knee discomfort is a common complaint. It’s next to impossible to straighten or bend the knee to its fullest. Sitting for a prolonged time stiffens the knee. The knee can “give out” or temporarily lock in place.
Rest is mandatory for bone healing. If the loose piece of bone continues to stir up trouble for six or more weeks, an orthopedic doctor can take a look inside the joint with a scope and scoop out the “mouse” or “mice.”
Dear Dr. Donohue: What’s the difference between “getting winded” and “having the wind knocked out of you”? How do you treat both if they are different? — J.M.
Dear J.M.: There’s a big difference.
“Getting winded” is simply not being able to breathe in enough oxygen to support whatever exercise a person happens to be doing. Treatment is rest. Prevention hinges on training the body to use oxygen more efficiently. That comes from practice.
“Having the wind knocked out of you” results from a blow to the center of the upper abdomen, about midway between the breastbone and the navel. In that area, there is a network of nerves that supplies the diaphragm, the breathing muscle.
A blow shuts down nerve transmission to the diaphragm, resulting in a temporary breathing paralysis. The condition is short-lived. If you are trying to assist someone who’s had the wind knocked out, try to get the person to relax. Encourage inhaling through the nose and exhaling through the mouth.
Don’t pull upward on the person’s belt. That does not help matters one bit.
Write to Paul Donohue, M.D., P.O. Box 536475, Orlando, FL 32853-6475.
