Osteochondroses

Question 1

what are some general features of osteochondroses? (in terms of gender, which limbs are invoilved, uni/bilateral?)

Answer 1

• common during the middle years of growth
• affects boys> females
• lower limbs more frequently involved
• approx. 15% bilateral

Question 2

what is osteochondroses?

Answer 2

decrease of blood flow to the growth plate causing aseptic necrosis of the bone

Question 3

what happens in the early phase of necrosis?

Answer 3

(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

Question 4

state the steps of the pathogenesis of osteochondroses.

Answer 4

1. phase of avascularity
2. phase of revascularization
3. phase of bone healing
4. phase of residual deformity

Question 5

what happens in the phase of revascularization w/ bone deposition and resorption?

Answer 5

• stage represents a vascular rxn of the surrounding tissue to dead bone
• is the most vulnerable stage of osteochondrosis

Question 6

what is the most vulnerable stage of osteochondrosis?

Answer 6

phase of revascularization

Question 7

what happens in the phase of bone healing?

Answer 7

• bone resorption ceases, but bone deposition continues

- newly formed bone still exhibits biological plasticity

Question 8

what happens in the phase of residual deformity?

Answer 8

• once bony healing of the epiphysis is complete, its contour remains unchanged
• if any residual deformity is present, it will remain

Question 9

Name this disease: ischemic necrosis of the femoral head.

Answer 9

Legg-Calve-Perthes disease

Question 10

what are the etiology for Legg-Calve-Perthes disease?

Answer 10

(occlusion of the blood supply to the femoral head) due to:

1. excessive fluid pressure of a synovial effusion
2. inflammatory or traumatic

Question 11

Give some S/S of Legg-Calve- Perthes disease.

Answer 11

• pain in the region of the hip
• antalgic gait
• limited ROM (abduction and internal rotation)
• disuse atrophy

Question 12

what are the 4 stages of Legg-calves-perthes disease?

Answer 12

1. incipient or synovitis phase
2. aspetic necrotic/avascular stage
3. regenerative/fragmentation stage
4. residual stage

Question 13

what is treatment of LCPD aimed at?

Answer 13

• preventing deformity of the femoral head and degenerative changes in the hip
• abduction cast or brace

Question 14

Name the disease: osteochondrosis of the tibial tuberosity.

Answer 14

Osgood’s Schlatter’s disease

Question 15

what age group does Osgood’s schlatter’s disease affect?

Answer 15

males (10-15 y/o)

Question 16

clinical symptoms of Osgood’s schlatter’s dz?

Answer 16

• soft tissue edema
• redness/painful
• difficulty walking

Question 17

describe the radiographic findings for osgood schlatter’s dz seen in the acute phase.

Answer 17

soft tissue swelling anterior to tibial tuberosity

Question 18

describe the radiographic findings for osgood schlatter’s dz seen in the chronic phase.

Answer 18

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

Question 19

what is the treatment for osgood schlatter’s dz?

Answer 19

anti-inflammatory and decrease sporting activities

Question 20

Name this disease: osteochondrosis of the navicular.

Answer 20

Kohler’s disease

Question 21

what are some radiographic findings of Kohler’s disease.

Answer 21

• flattening of the navicular

- irregular rarefactions & sclerosis

Question 22

what is the treatment for Kohler’s disease?

Answer 22

below knee walking cast

Question 23

Name this dz: avascular necrosis of metatarsal head.

Answer 23

freibergs infarction

Question 24

what is the % of incidence that the 2nd met is affect in freibergs infarction?

Answer 24

68%

Question 25

what is the % of incidence that the 3rd met is affected in friebergs infarction?

Answer 25

27%

Question 26

what is the etiology for freibergs infarction?

Answer 26

1. Similie- occurs secondary to traumatic process

2. Braddock: secondary to fracture modified by its proximity to the epiphyseal plate

Question 27

explain the classification system for freibergs infarction.

Answer 27

stage 1. epiphyseal fissure fracture

2. central portion of bone reabsorption
3. metatarsal head begins to flatten
4. articular loose body
5. complete flattening of the metatarsal

Question 28

radiographic findings of freibergs infarction?

Answer 28

-widening of joint space with effusion

Question 29

Name this disease: osteochondrosis of the calcaneus.

Answer 29

sever’s disease

Question 30

what is the most common contributing factor for sever’s disease?

Answer 30

increasing level of activity

Question 31

Name this dz: osteochondrosis of the phalanges.

Answer 31

Thiemann’s

Question 32

Name this disease: osteochondrosis of the styloid process.

Answer 32

islen’s disease

Question 33

Name this disease: osteochondrosis of the cuneiform bones.

Answer 33

buschke’s disease

Question 34

Name this disease: osteochondrosis of the talus.

Answer 34

Diaz disease

Question 35

Name this disease: osteochondrosis of the sesamoids.

Answer 35

Treve disease

Question 36

what is osteochondritis dessicans?

Answer 36

basic disturbance due to epiphyseal development