• See Also
  1. Apophysitis
  2. Osteochondritis Dissecans
  • Pathophysiology
  1. Transient disruption of a joints bone-cartilage complex
    1. Results in abnormal growth, injury or degeneration of developing Growth Plate
    2. Affects contiguous Ossification Centers in the immature skeleton
    3. Unknown underlying mechanism (e.g. repetitive Trauma, vascular abnormality, genetic factors)
  2. Precaution: Naming Alert
    1. Osteochondrosis is NOT the same as Osteochondritis Dissecans
  • Epidemiology
  1. Overall, uncommon conditions
  2. Gender: Boys more commonly affected
  3. Age: Most common between ages 10-14 years old
  • Symptoms
  1. Pain or Disability at the affected joint
  • Types
  1. Back
    1. Scheuermann Disease (humpback deformity)
  2. Elbow
    1. Medial Epicondyle Apophysitis
    2. Panner Disease (Lateral elbow capitellum degeneration)
  3. Foot
    1. Sever Disease (Calcaneal Apophysitis)
    2. Frieberg Disease (second Metatarsal head)
    3. Kohler Bone Disease (Tarsal Navicular)
  4. Knee
    1. Osgood-Schlatter Disease (Patellar tendon insertion at tibial tubercle Apophysitis)
    2. Sinding-Larsen-Johansson Disease (inferior pole Patella)
  5. Hip
    1. Legg-Calve-Perthes Disease
  • Images
  1. Osteochondrosis Sites
    1. OrthoPedsApophysitisOsteochondrosis.jpg
  • Differential Diagnosis
  1. Traumatic Injury
  2. Stress Fracture
  3. Avulsion Fracture
  4. Bony Lesions (e.g. Cancer)
  5. Osteomyelitis
  6. Inflammatory Arthropathy (multiple joints involved)
  • Management
  1. See specific conditions for management
  2. Conservative therapy
    1. Relative rest
    2. Ice Therapy
    3. NSAIDs (judicious use)
  3. Orthopedic or sports medicine Consultation indications
    1. Symptoms persists for more than 4-6 months
    2. Red Flags (severe pain, Trauma, inability to bear weight, night pain, systemic symptoms, cancer history)
  • Course
  1. Osteochondrosis is self limited to the growth period and resolves once skeletal maturity is reached
  • References
  1. Atanda (2011) Am Fam Physician 83(3): 285-91 [PubMed]