Osteochondritis and Perthes Disease

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.
Perthes’ Disease:-
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
Stages:
1. Stage of synovitis
2.Stage of Trabecular necrosis
3.Stage of healing
Presentation-
- 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.
Treatment-
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.
Further Reading:
Patients Reading: patientcouk
1 Comment
Hello
What are all the phases of perthes and duration of these phases. What is the proven treatment for this perthes.
Rgards
N. Suresh
Comments are closed.