Osteochondritis/ AVN Flashcards
kohl's disease Sever's disease Iselin's disease
1
Q
What is this?
A
- Kohler’s disease
- avn of navicular
- unknown aetiology
2
Q
Describe the epidemiolgy of kohler’s disease?
A
- occurs in young children 4-7 years
- 4x more common in boys cf girls
- 80% cases in boys
3
Q
Describe the pathophysiology of Kohler’s disease?
A
- the blood supply o fhte central 1/3 rd of navicular is watershed zone
- accounts for susceptibility to avn and stress fx
4
Q
What is the prognosis of Kohler’s disease?
A
- typically self- limiting condition
- intermittent symptoms for 1-3 yrs post dx
- typically associated wth activity
5
Q
What are the signs and symptoms of kohler’s disease?
A
Symptoms
- Midfoot pain with associated limp
- Pain in dorsalmedial foot
- may have swelling, warmth
- Point tenderness over navicular
Signs
- Antalgic limp
6
Q
What is seen on xray with kohler’s disease?
A
- sclerosis, flattening and fragmentation of navicular
- most reorganise after if not they deform but most remain asymptomatic
7
Q
What is the tx for kohler’s disease?
A
Non operative
- NSAIDS
-
Short walking cast
- if pain with activities
- outcome- decrease duration of symptoms
- xrays improve 6-48 mo post symptoms
- no reports of longterm disability
- No indications for surgery
8
Q
What is this?
A
- Iselin’s disease
- traction apophysitis of the tuberosity of 5th MT
- Often seen in active boys/girls between 8-13 yrs
- common in soccer players/dancers
9
Q
What are the signs and symptoms of Iselin’s disease?
A
- Pain on lateral foot that is worse with activity
- tenderness over 5th MT
- xrays are norrmal
10
Q
What is the tx of Iselin’s disease?
A
Non operative
- Rest, activity modification, icing
11
Q
What is Sever’s disease?
A
- Common cause of heel pain
- thought to be an overuse injury of calcaneal apophysis in the growing child
12
Q
What is the epidemiology of Sever’s disease?
A
- Commonly seen in immature atheletes in running and jumping sports
- frequently seen just before or during peak growth
13
Q
What is the aetiology of Sever’s disease?
A
- Unknown
- Due to traction apophysitis and repititive microtrauma esperienced during gait
- similar to Osgood schlatter’s disease
14
Q
What is the prognosis of Sever’s disease
A
- Self limiting
- Resolves with maturation & closure of apophysis
15
Q
What are the signs and symptoms of Sever’s disease?
A
Symptoms
- Pain in area of calcaneal apophysis in immature atheletes
- Pain with increased activity/impact
- can display warmth
Signs
- Tight achilles tendon
- positive squeeze test- pain with medial-lateral compression over tuberosity of the calcaneus
- pain over calcaneal apophysis
16
Q
What is seen on xray of Sever’s disease?
A
- Sclerosis maybe present in pt with/wout calcaneal apophysitis
- fragmentation is more frequently seen in Sever’s disease
