This simple test is used to diagnose osteochondritis dissecans of the knee as part of a physical examination. The condition means bone and cartilage have broken loose in your knee joint.
If a doctor or healthcare professional suspects that you have osteochondritis dissecans of the knee, you may undergo a Wilson’s test. It’s a simple test that involves turning and extending your leg and noting when the movement becomes painful and what it takes to relieve that pain.
Osteochondritis dissecans is a rare condition, affecting about 200,000 Americans. It can sometimes heal on its own, though more severe osteochondritis dissecans may require surgery.
Before any treatment options can be considered, you need to have an accurate diagnosis. Osteochondritis dissecans can be confused with a different condition called avascular necrosis of the knee, which is a painful condition that happens when the blood flow to your knee is reduced or stopped.
Wilson’s test is one way to help get an accurate diagnosis.
Learn more about osteochondritis dissecans.
If you have osteochondritis dissecans of the knee, it means a piece of cartilage and a layer of bone underneath it have pulled away or broken off from the end of a bone in your knee joint. If the loose pieces of bone and cartilage are small and remain close to the bone, they may cause no symptoms and heal on their own.
If the broken pieces move within your joint, they can cause pain and affect how your knee bends and straightens. The condition can also cause your joint to weaken, making it difficult to run, jump, or even stand for long periods of time.
Wilson’s test can be part of a more thorough physical examination of your affected leg and knee joint. It’s noninvasive – doesn’t require anything to be inserted into your body – and can help reveal what part of your knee joint has been affected by osteochondritis dissecans. It takes less than a minute and can be done in any doctor’s office or even at home.
A Wilson’s test by itself is usually not enough to diagnose osteochondritis dissecans of the knee. A doctor will also likely check your affected knee for swelling, tenderness, and reduced range of motion, as well as the specific painful parts of your leg and knee.
Imaging, including X-rays and magnetic resonance imaging (MRI), may also be used to reveal the location and nature of the problems affecting your knee.
An X-ray of both knees can show a comparison of a healthy knee to an injured one, as well as the extent of the injury. An MRI also can show whether the affected cartilage and bone are still close to where they originated or if they have moved within your joint.
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A Wilson’s test is usually done in a doctor’s office or other clinical setting. You sit up with your knees bent and both legs dangling off the side or end of a table. A doctor or other healthcare professional will take your affected leg and slightly turn the ankle inward, which causes your tibia (shinbone) to also rotate inward.
You’ll then slowly straighten that leg out until you experience pain in your knee. If pain starts after the ankle is turned but before your leg is completely straight, the healthcare professional will gently turn the ankle outward. If this relieves the pain, the Wilson’s test result is likely positive for osteochondritis dissecans.
If rotating your ankle doesn’t affect your pain or if you have other symptoms that might suggest a different injury or condition, the Wilson’s test may be negative. In that case, other tests or imaging may be necessary to make a diagnosis.
If you have a positive Wilson’s test and a confirmed diagnosis of osteochondritis dissecans, your outlook will depend largely on the severity of your injury.
A 2018 report suggests that while the condition often fails to fully heal when it develops in older adults, most children and adolescents treated for osteochondritis dissecans of the knee can usually experience a full recovery.
If you need surgery, you may need to be on crutches for several weeks afterward. The surgeon can give an idea about how many weeks you may need to use crutches. Many people need them for at least 6 weeks.
You’ll likely need a few months of physical therapy as well to help you regain strength, stability, and flexibility in your knee. A return to sports and all other activities is usually possible within 6 months. But a doctor may advise you to avoid high impact sports and other activities if the initial injury is severe and the stability of your knee is seriously affected.
How do you know if you have a joint mouse?
A joint mouse is a loose piece of bone or cartilage inside your knee or other joint. One of the main symptoms is your joint locking, or when your knee becomes difficult to bend or straighten. You may also feel something moving or shifting within your joint.
What causes osteochondritis dissecans in the knee?
It’s not always clear why a person develops osteochondritis dissecans of the knee, though the American Academy of Orthopaedic Surgeons suggests that repeated stress or trauma to your knee may be one cause.
Repeated stress or trauma can also be associated with avascular necrosis. Individuals who play sports with high impact contact or landings, such as football or gymnastics, may be at higher risk.
Is there a cure for osteochondritis dissecans in the knee?
Osteochondritis dissecans of the knee can usually be treated with rest and conservative measures. With more severe osteochondritis dissecans, arthroscopic or open surgery may be necessary to reattach the loose sections of bone and cartilage.
In some cases, other treatment options may be necessary, such as surgery using pins or screws to secure the broken pieces back to your bone, bone grafts, or cartilage from a donor.
Accurate diagnosis of any health concern is critical, as it helps determine what treatment plan, if any, is right for you.
Wilson’s test is one easy way for a healthcare professional to narrow the list of possible causes of your knee symptoms. Even with a positive Wilson’s test, a doctor will most likely order an X-ray and an MRI as well.
Whether the Wilson’s test result is negative or positive, the findings can be helpful in getting you back on your feet and feeling better.