A group of miscellaneous affections of the growing epiphyses in children and adolescents. Typically , a bony nucleus of the epiphysis affected by osteochondritis is temporarily softened and is likely to get deformed by pressure in this stage.
Osteochondritis is sometimes classified as-
- Crushing type or Osteochondrosis
- Osteochondritis dissecans
- Tractions Osteochondritis or traction apophysistis
Common Osteochnodrites –
- Perthes’ disease – Head of femur is affected
- Panner’s disease- Capitulum affected
- Kienbock’s disease- Lunate bone affected
- Osgood-shlatter’s disease- Tibial tuberosity Osteochondritis
- Sever’s disease- Calcaneal tuberosity Osteochondritis
- Kohler’s disease- Navicular bone affected
- Freiberg’s Disease- Metatarsal head affected
- Scheurmann’s disease- Ring epiphyses of vertebra affected
- Calve’s disease- Centralbody of nucleus of vertebral body affected.
Aka. Coxa Plana, Pseudocoxalgia
This is the Osteochondritis of the epiphysis of the femoral head. In the disease, the femoral head becomes partially or completely avascular and deformed as well.
Cause- not exactly known. ? recurrent ischemia of head of femur in susceptible age group. Usually precipitated by Synovitis
Age Group Susceptible- 5- 10 years Gender- Boys> Girls
1. Stage of synovitis
2.Stage of Trabecular necrosis
3.Stage of healing
- Pain in the hip region, pain may radiate to knees.
- Hipstiffness and limping may be present
- On examination- not much findings, sometimes there is shortening of the affected limb, and the limb may be externally rotated and abducted.
X-Ray- Collapse and sclerosis od the epiphysis of the femoral head. Joint space increased- hip joint.
Bone scan- decreased uptake by femoral head.
Principle- preventing the Head from deforming in the softening phase, while keeping it in acetabulaum while revascularization takes place (Head Containment)
Methods- Plaster, special Braces, Splints, Operation- containment- osteotomy.
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