|Specialty||Rheumatology, orthopedic surgery|
Osteochondrosis is a family of orthopedic diseases of the joint that occur in children, adolescents and rapidly growing animals, particularly pigs, horses, dogs, and broiler chickens. They are characterized by interruption of the blood supply of a bone, in particular to the epiphysis, followed by localized bony necrosis, and later, regrowth of the bone. This disorder is defined as a focal disturbance of endochondral ossification and is regarded as having a multifactorial cause, so no one thing accounts for all aspects of this disease.
Signs and symptoms
These conditions nearly all present with an insidious onset of pain referred to the location of the bony damage. Some, notably Kienbock's disease of the wrist, may involve considerable swelling, and Legg-Calvé-Perthes disease of the hip causes the victim to limp. The spinal form, Scheuermann's disease, may cause bending, or kyphosis of the upper spine, giving a "hunch-back" appearance.
The ultimate cause for these conditions is unknown, but the most commonly cited cause factors are rapid growth, heredity, trauma (or overuse), anatomic conformation, and dietary imbalances; however, only anatomic conformation and heredity are well supported by scientific literature. The way that the disease is initiated has been debated. Although failure of chondrocyte differentiation, formation of a fragile cartilage, failure of blood supply to the growth cartilage, and subchondral bone necrosis all have been proposed as the starting point in the pathogenesis, recent literature strongly supports failure of blood supply to growth cartilage as most likely.
In humans, these conditions may be classified into three groups:
- Spinal: Scheuermann's disease (of the interspinal joints) which is a curve in the thoracic spine.
- Articular: Legg-Calvé-Perthes disease (or, avascular necrosis of the femoral head in the hip), Köhler's disease (of the tarsal navicular bone of the foot), Panner's disease (of the capitulum of the elbow), Freiberg's infraction (of the second or third metatarsal of the foot and less frequently the first or fourth; sometimes called Freiberg's Infraction or Freiberg's disease), Blount's disease (tibia vara), Kienböck´s disease (lunate). Other entities affecting mostly adults, but sometimes loosely lumped into these conditions include Preiser's disease (scaphoid) and Muller-Weiss syndrome (tarsal navicular).
- Non-articular: This group includes Sever's disease (of the calcaneus, or heel), and other conditions not completely characteristic of the osteochondroses, such as Osgood-Schlatter's disease (of the tibial tubercle) and Sinding-Larsen-Johansson syndrome (proximal patellar tendon).
The term osteochondrosis has been used to describe a wide range of lesions among different species. There are different types of the prognosis: latens, which is a lesion restricted to epiphyseal cartilage, manifesta, a lesion paired with a delay in endochondral ossification, and dissecans which is a cleft formation in the articular cartilage. The prognosis for these conditions is very variable, and depends both on the anatomic site and on the time at which it is detected. In some cases of osteochondrosis, such as Sever's disease and Freiberg's infraction, the involved bone may heal in a relatively normal shape and leave the patient asymptomatic. On the contrary, Legg-Calvé-Perthes disease frequently results in a deformed femoral head that leads to arthritis and the need for joint replacement.
- Ytrehus B, Carlson CS, Ekman S (July 2007). "Etiology and pathogenesis of osteochondrosis". Vet. Pathol. 44 (4): 429–48. doi:10.1354/vp.44-4-429. PMID 17606505. Archived from the original on 2009-01-31. Retrieved 2008-10-03.
- "osteochondrosis" at Dorland's Medical Dictionary
- "Medical College of Wisconsin". Archived from the original on 2012-02-04. Retrieved 2005-12-10.
- "Bone Scintigraphy in Kienbock's Disease". Retrieved 2008-11-17.
- "Legg-Calvé-Perthes Disease". Retrieved 2008-11-17.
- "Scheuermann's Disease - Orthogate - Improving orthopedic care, education and research with Internet technologies". Retrieved 2008-11-17.
- "Sever's Disease - The Southern California Orthopedic Institute". Archived from the original on 2012-07-22. Retrieved 2008-11-17.
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