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(3) Osteochondroses Flashcards

1
Q

What are osteochondroses?

A

epiphyseal/apophyseal conditions characterized by fragmentation, sclerosis, & irregular articular surfaces
(may be true AVN, post-traumatic deformity, or developmental variation)

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2
Q

What is the term for AVN of the femoral head in a child?

A

Legg-Calve-Perthes (LCP)

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3
Q

What is the term for osteochondrosis of the metatarsal heads?

A

Freiberg disease

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4
Q

What is the term for AVN of the lunate?

A

Keinbock disease

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5
Q

What is the term for osteochondrosis of the tibial tuberosity?

A

Osgood-Schlatter disease

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6
Q

What is the term for osteochondrosis of the inferior pole of the patella?

A

Sinding-Larsen-Johansson (SLJ)

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7
Q

What is the term for osteochondrosis of the thoracic spine?

A

Scheuermann disease

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8
Q

What is the term for osteochondrosis of the vertebral bodies?

A

Kummell disease

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9
Q

What is the term for osteochondrosis of the femoral condyles?

A

Osteochondral fracture (OCD)
(absolutely not SONK)

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10
Q

What is the term for osteochondrosis of the ischiopubic synchondrosis?

A

Van Neck Disease

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11
Q

What is the term for AVN of the femoral head in adults?

A

Chandler disease

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12
Q

What is the term for osteochondrosis of the medial tibial condyle?

A

Blount disease

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13
Q

What is the term for osteochondrosis of the calcaneal apophysis?

A

Sever disease
(= calcaneal apophysitis)

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14
Q

What is the term for osteochondrosis of the navicular in kids?

A

Kohler disease

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15
Q

What is the term for osteochondrosis of the talus?

A

Diaz disease

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16
Q

What is the term for osteochondrosis of the capitellum?

A

Panner disease

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17
Q

What is the term for AVN of the proximal pole of the scaphoid?

A

Preiser disease

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18
Q

What is the term for osteochondrosis of the humeral head?

A

Hass disease

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19
Q

What age group is affected by Legg-Calve-Perthes?

A

3-12 yrs
(younger than SCFE)

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20
Q

What sex is more commonly affected by Legg-Calve-Perthes?

A

M>F (5:1)

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21
Q

What are the clinical features of Legg-Calve-Perthes?

A
  • age 3-12 yrs, M>F
  • 10% bilateral
  • painful limp (referred knee pain)
  • reduced ROM
  • positive Trendelenburg test
  • 2* DJD in adulthood
  • entire process takes 2-8 yrs
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22
Q

What are the early imaging findings of Legg-Calve-Perthes?

A
  • soft tissue swelling
    • Waldenstrom sign
  • small, flattened femoral head
  • epiphyseal fragmentation
  • sclerosis
  • crescent sign
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23
Q

What is Waldenstrom sign?

A

medial hip joint space:
- >2mm difference side to side
- >11mm absolute value (on one side)

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24
Q

What are the later imaging findings of Legg-Calve-Perthes?

A
  • mushroom deformity
  • wide, short femoral neck
  • coxa vara/magna/plana
  • enlarged greater trochanter
  • sagging rope sign
  • degeneration
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25
Q

What population sees an increased frequency of Freiberg disease?

A

women who wear high heels
(fatigue Fx of MT head causes collapse)

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26
Q

What population sees an increased frequency of Osgood-Schlatter disease?

A

pediatric athletes (running sports) –> eventual overgrowth lasting into adulthood

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27
Q

What are 2 other names for Scheuermann disease?

A
  • Juvenile kyphosis (d/t ant wedging)
  • vertebral epiphysitis
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28
Q

What spinal regions are affected by Scheuermann disease?

A
  • midthoracic (75%)
  • thoracolumbar (25%)
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29
Q

What treatment modification should you make for patients with Scheuermann disease?

A

mobilization only (d/t rigid hyperkyphosis)

30
Q

What is the diagnostic criteria for Scheuermann disease?

A

anterior wedging:
- >5 deg
- 3 contiguous segments

31
Q

What are the imaging findings associated with Scheuermann disease?

A
  • anterior wedging
  • irregular endplates (Schmorl nodes)
  • loss of disc height
  • hyperkyphosis (>40 deg)
32
Q

What is another name for Sinding-Larsen-Johansson disease?

A

Jumper’s knee

33
Q

What population sees an increased frequency of Sinding-Larsen-Johansson disease?

34
Q

What radiographic sign is characteristic of Kummel disease?

A

intravertebral vacuum phenomenon

35
Q

What deformity is caused by Blount disease?

A

varus deformity of the knee

36
Q

What causes Blount disease?

A

developmental variation in medial tibial plateau growth center

37
Q

What fracture predisposes a patient to Diaz disease?

A

aviator Fx

38
Q

What population sees an increased frequency of Panner disease?

A

baseball pitchers

39
Q

How does Sever disease appear radiographically?

A

normal (sclerotic)
(clinical Dx: painful squeeze)

40
Q

Give 3 differentials in order of likelihood.

A
  1. Infarct
  2. Chondrosarcoma
  3. Enchondroma
41
Q

What is the diagnosis?

A

Chandler Dz

42
Q

What is the radiographic sign?

A

Crescent sign

43
Q

What is the diagnosis?

A

Chandler Dx

44
Q

What is shown in this bone scan?

A

Photopenia
(Dx: AVN in avascular stage)

45
Q

What is the term for the appearance of the interface between necrotic bone and living bone on an MRI?

A

Double line sign

46
Q

What are the radiographic findings?

A
  • small femoral head, flattening
  • positive Waldenstrom sign
    (Dx: LCP)
47
Q

What radiographic sign is seen here?

A

Mushroom deformity
(Dx: LCP)

48
Q

What is the diagnosis?

A

LCP
(Sign: mushroom deformity)

49
Q

What is the diagnosis?

A

Chandler Dz

50
Q

What is the diagnosis?

51
Q

What is the diagnosis?

A

Keinböck Dz

52
Q

What is the diagnosis?

A

Freiberg Dz

53
Q

What is the diagnosis? What imaging follow-up is needed?

A

osteochondritis dissecans (OCD)
MRI arthrogram

54
Q

What is the diagnosis?

A

Subchondral insufficiency fracture

55
Q

What is the diagnosis?

56
Q

What is the diagnosis?

A

Subchondral insufficiency Fx

57
Q

What is the diagnosis?

A

Scheuermann Dz

58
Q

What is the diagnosis?

59
Q

What is the diagnosis?

A

Van-neck disease

60
Q

What is the diagnosis?

A

Blount disease

61
Q

What is the diagnosis?

A

Diaz disease

62
Q

What is the diagnosis?

A

Hass disease

63
Q

What is the diagnosis?

A

Köhler disease

64
Q

What is the diagnosis?

A

Preiser disease

65
Q

What is the diagnosis?

A

Blount disease

66
Q

What is the diagnosis?

A

Köhler disease

67
Q

What is the diagnosis?

A

Panner disease

68
Q

What is the diagnosis?

A

Diaz disease

69
Q

What is the diagnosis?

A

Köhler disease

70
Q

What is the diagnosis?

A

Hass disease

71
Q

Patient has pain when squeezing the Achilles. What is the diagnosis?

A

Sever disease

72
Q

What is the diagnosis?

A

Hass disease

NYCC Bone & Joint (72 decks)

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