# Bilateral Femoral Head Osteochondritis Dissecans in an Adolescent: A Report of a Rare Case

## TL;DR

A rare case of bilateral hip OCD in an adolescent is reported, emphasizing early diagnosis and conservative treatment.

## Contribution

This paper presents a rare case of bilateral femoral head OCD in an adolescent without trauma or repetitive stress.

## Key findings

- Bilateral subchondral lucencies in femoral heads were detected via radiography and confirmed stable via MRI.
- Conservative management was recommended due to preserved function and stable OCD lesions.
- Early diagnosis is highlighted to prevent progression and complications like osteoarthritis.

## Abstract

Osteochondritis dissecans (OCD) is an uncommon condition involving the subchondral bone and overlying cartilage, typically affecting the knee. Its occurrence in the hip is rare, and bilateral involvement of the femoral heads is considered exceedingly uncommon, especially in the absence of trauma or repetitive stress. We present the case of an 18-year-old female with bilateral anterior hip pain, mainly when transitioning from standing to sitting. She reported no history of trauma, athletic activity, or systemic symptoms. Physical examination revealed normal gait and full range of hip motion without any pain. Laboratory investigations were within normal range. Anteroposterior pelvic radiographs showed bilateral subchondral lucencies in the femoral heads. MRI confirmed stable OCD lesions centered at the fovea capitis, without signs of articular surface disruption, fluid clefts, or fragment instability. Given the imaging features and the patient’s preserved function, conservative management was recommended. This case highlights the importance of considering hip OCD in adolescents with vague hip pain and emphasizes the diagnostic value of plain radiography in early detection and MRI in further characterization. Early recognition can help in preventing disease progression and reduce the risk of long-term complications such as osteoarthritis.