Most OCDs will progress. In an OCD the cartilage is detached from the underlying bone. Once this happens the cartilage never reattaches on its own, but it doesn't necessarily guarantee pain. The progression of size and pain depends on the location, nature of the lesion and activity of the patient.
Once it becomes painful, it is best to have something done whether it is a brace, an ankle scope or something more involved such as cartilage replacement.
The doctor said it was small. It is located in the lateral portion of the talor dome. I never had any problems there until I had an accident at work. A couple of weeks after it I began having aching at the joint. He gave me a shot of lidocaine in the joint and it has calmed down. Hopefully it will be ok as the doctor also feels I will need flat foot reconstruction surgery sooner rather then later on this foot.