Osteochondroses Flashcards
what are some general features of osteochondroses? (in terms of gender, which limbs are invoilved, uni/bilateral?)
- common during the middle years of growth
- affects boys> females
- lower limbs more frequently involved
- approx. 15% bilateral
what is osteochondroses?
decrease of blood flow to the growth plate causing aseptic necrosis of the bone
what happens in the early phase of necrosis?
(phase of avascularity)
- osteocytes and bone marrow cells die
- ossific nucleus of the epiphysis ceases to growh
- articular cartilage remains alive and grows
- disuse atrophy (osteoporosis)
- asymptomatic
state the steps of the pathogenesis of osteochondroses.
- phase of avascularity
- phase of revascularization
- phase of bone healing
- phase of residual deformity
what happens in the phase of revascularization w/ bone deposition and resorption?
- stage represents a vascular rxn of the surrounding tissue to dead bone
- is the most vulnerable stage of osteochondrosis
what is the most vulnerable stage of osteochondrosis?
phase of revascularization
what happens in the phase of bone healing?
- bone resorption ceases, but bone deposition continues
- newly formed bone still exhibits biological plasticity
what happens in the phase of residual deformity?
- once bony healing of the epiphysis is complete, its contour remains unchanged
- if any residual deformity is present, it will remain
Name this disease: ischemic necrosis of the femoral head.
Legg-Calve-Perthes disease
what are the etiology for Legg-Calve-Perthes disease?
(occlusion of the blood supply to the femoral head) due to:
- excessive fluid pressure of a synovial effusion
- inflammatory or traumatic
Give some S/S of Legg-Calve- Perthes disease.
- pain in the region of the hip
- antalgic gait
- limited ROM (abduction and internal rotation)
- disuse atrophy
what are the 4 stages of Legg-calves-perthes disease?
- incipient or synovitis phase
- aspetic necrotic/avascular stage
- regenerative/fragmentation stage
- residual stage
what is treatment of LCPD aimed at?
- preventing deformity of the femoral head and degenerative changes in the hip
- abduction cast or brace
Name the disease: osteochondrosis of the tibial tuberosity.
Osgood’s Schlatter’s disease
what age group does Osgood’s schlatter’s disease affect?
males (10-15 y/o)
clinical symptoms of Osgood’s schlatter’s dz?
- soft tissue edema
- redness/painful
- difficulty walking
describe the radiographic findings for osgood schlatter’s dz seen in the acute phase.
soft tissue swelling anterior to tibial tuberosity
describe the radiographic findings for osgood schlatter’s dz seen in the chronic phase.
type 1- tibial tuberosity prominent & irregular
type 2- same as above w/ small free particle of bone located at the anterior tuberosity
type 3- normal tuberosity with bone particle
what is the treatment for osgood schlatter’s dz?
anti-inflammatory and decrease sporting activities
Name this disease: osteochondrosis of the navicular.
Kohler’s disease
what are some radiographic findings of Kohler’s disease.
- flattening of the navicular
- irregular rarefactions & sclerosis
what is the treatment for Kohler’s disease?
below knee walking cast
Name this dz: avascular necrosis of metatarsal head.
freibergs infarction
what is the % of incidence that the 2nd met is affect in freibergs infarction?
68%
what is the % of incidence that the 3rd met is affected in friebergs infarction?
27%
what is the etiology for freibergs infarction?
- Similie- occurs secondary to traumatic process
2. Braddock: secondary to fracture modified by its proximity to the epiphyseal plate
explain the classification system for freibergs infarction.
stage 1. epiphyseal fissure fracture
- central portion of bone reabsorption
- metatarsal head begins to flatten
- articular loose body
- complete flattening of the metatarsal
radiographic findings of freibergs infarction?
-widening of joint space with effusion
Name this disease: osteochondrosis of the calcaneus.
sever’s disease
what is the most common contributing factor for sever’s disease?
increasing level of activity
Name this dz: osteochondrosis of the phalanges.
Thiemann’s
Name this disease: osteochondrosis of the styloid process.
islen’s disease
Name this disease: osteochondrosis of the cuneiform bones.
buschke’s disease
Name this disease: osteochondrosis of the talus.
Diaz disease
Name this disease: osteochondrosis of the sesamoids.
Treve disease
what is osteochondritis dessicans?
basic disturbance due to epiphyseal development
