Osteochondritis dissecans of both knees, both elbows, and the first metatarsophalangeal joint in a female soccer player.

A 19-year-old female soccer player presented for evaluation of pain at the base of the right hallux after a recent sports injury. She had a history of 4 operations, 1 each at both knees and both elbows, for the treatment of osteochondritis dissecans (OCD). Examination showed tenderness to palpation and limited range of motion of the first metatarsophalangeal (MP) joint, and radiographs showed stage 4 OCD of the first metatarsal head with a detached osseous fragment. Diagnostic arthroscopy confirmed the presence of OCD, and treatment included arthrotomy, excision of the loose body, and microfracture of the defect. Evaluation at 3 months after surgery showed that the first MP joint pain and limited motion had completely resolved, and the patient returned to soccer practice. Although OCD at 1 location is diagnosed frequently in athletes, involvement of 5 different joints in the same patient is uncommon.