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Osteochondritis dissecans of the capitellum is seen most commonly in adolescents. Usually repetitive motion, e.g., throwing, or activities that increase the load across the elbow, e.g., gymnastics, are causative factors. Initial symptoms may be pain, loss of motion (especially extension), catching, locking, or swelling. Diagnosis is made by plain x-rays, although computed tomography (CT) and/or magnetic resonance imaging (MRI) are sometimes required. Initial treatment is conservative unless the patient presents with an advanced stage. Recommended surgery is elbow arthroscopy with removal of all loose fragments and abrasion chondroplasty, followed by early active motion and strengthening. This allows return to activities in most individuals.