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-

  1. Crushing type or Osteochondrosis
  2. Osteochondritis dissecans
  3. Tractions Osteochondritis or traction apophysistis

Common Osteochnodrites –

  1. Perthes’ disease – Head of femur is affected
  2. Panner’s disease- Capitulum affected
  3. Kienbock’s disease- Lunate bone affected
  4. Osgood-shlatter’s disease- Tibial tuberosity Osteochondritis
  5. Sever’s disease- Calcaneal tuberosity Osteochondritis
  6. Kohler’s disease- Navicular bone affected
  7. Freiberg’s Disease- Metatarsal head affected
  8. Scheurmann’s disease- Ring epiphyses of vertebra affected
  9. 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:

AAOS

Patients Reading: patientcouk

One Reply to “Osteochondritis and Perthes Disease”

  1. Hello
    What are all the phases of perthes and duration of these phases. What is the proven treatment for this perthes.

    Rgards

    N. Suresh

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