Osteochondroses Flashcards
Name some articular osteochondroses.
Perthes, Kohler’s, Frieberg’s
Name some non-articular osteochondroses.
Osgood-Schlatters, Sinnig-Larsen-Johansson lesion, Sever’s, Iselin’s lesion
Name some physical osteochondroses.
Sheuermann’s Kyphosis, Blount’s disease
What is a Kohler’s lesion and how is it caused?
Avascular necrosis of the navicular caused by repeated micro-trauma disturbing blood flow to the navicular.
The navicular is prone to avascular necrosis as it is the last bone to ossify and is subject to compression forces from surrounding bones.
How is a Kohler’s lesion diagnosed?
x-ray and clinical examination
What are the symptoms for a Kohler’s lesion?
- pain localised to the navicular
- pain with tib post contraction
- widened/flattened/irregular shaped navicular bone
Does Kohler’s affect boys or girls more?
Boys>girls, 4:1
What age is Kohler’s most common?
2-9 y.o.
How is Kohler’s treated?
- activity modification
- orthoses
- short leg cast 6-8 weeks
What is Frieberg’s lesion and how is it caused?
Avascular necrosis of the metatarsal head (usually 2nd met head, sometimes 3rd). Caused by repeated micro-trauma interrupts blood supply to the epiphyseal plate.
What are the symptoms for a Frieberg’s lesion?
- pain on WBing through the forefoot
- longer second ray? - push off through second rather than first
Is Frieberg’s more common in girls or boys?
F>M, often 12-15 y.o. dancers
How is Frieberg’s diagnosed?
xray, bone scan, MRI, clinical examination
What are DDX for Frieberg’s?
stress #, march #, synovitis, neuroma, RA
What are DDX for Kohler’s?
accessory navicular, #, trauma