II. 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

III. Epidemiology

  1. Overall, uncommon conditions
  2. Gender: Boys more commonly affected
  3. Age: Most common between ages 10-14 years old

IV. Symptoms

  1. Pain or Disability at the affected joint

V. 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

VI. Images

  1. Osteochondrosis Sites
    1. OrthoPedsApophysitisOsteochondrosis.jpg

VII. 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)

VIII. 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)

IX. Course

  1. Osteochondrosis is self limited to the growth period and resolves once skeletal maturity is reached

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Ontology: Osteochondrosis (C0029429)

Definition (MSH) Any of a group of bone disorders involving one or more ossification centers (EPIPHYSES). It is characterized by degeneration or NECROSIS followed by revascularization and reossification. Osteochondrosis often occurs in children causing varying degrees of discomfort or pain. There are many eponymic types for specific affected areas, such as tarsal navicular (Kohler disease) and tibial tuberosity (Osgood-Schlatter disease).
Definition (MSHCZE) Onemocnění kostí a chrupavky postihující zejm. oblasti v blízkosti kloubu (juvenilní o., srov. aseptická nekróza, epifyzeonekróza). Osteochondrosis osteochondritis deformans juvenilis – Scheuermannova nemoc. Osteochondrosis dissecans – ohraničená subchondrální nekróza v kloubu např. lokti, koleně, někdy vedoucí k uvolnění nekrotické části do kloubu tzv. „myšky“, srov. osteochondrolýza. Osteochondrosis intervertebralis – degenerativní změny meziobratlových plotének s reaktivní osteosklerózou obratlů a tvorbou osteofytů. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Concepts Disease or Syndrome (T047)
MSH D055034 , D010007
ICD10 M93.9
SnomedCT 123256004, 65477003, 156822009, 268125000, 19579005
English Epiphyseal ischemic necrosis, Osteochondrosis, OSTEOCHONDROSIS, Osteochondroses, Epiphyseal ischaemic necrosis, Osteochondrosis NOS, Osteochondrosis [Disease/Finding], osteochondrosis, osteochondroses, Osteochondrosis (disorder), Epiphyseal necrosis, Epiphyseal necrosis (disorder), Epiphyseal ischemic necrosis, NOS, Epiphyseal necrosis, NOS, Osteochondrosis, NOS, Epiphyseal necrosis -RETIRED-, Osteochondrosis not specified as adult or juvenile, of unspecified site
French OSTEOCHONDROSE, Nécrose ischémique épiphysaire, Ostéochondrose
Portuguese OSTEOCONDROSE, Necrose isquémica epifisária, Osteocondrose, Ostéocondrose
Dutch ischemische epifysenecrose, ischemische necrose van epifyse, osteochrondrose, Osteochondrose
German epiphysaere ischaemische Nekrose, Osteochondrose, Osteochondrosis
Italian Necrosi dell'epifisi, ischemica, Osteocondrosi
Spanish Necrosis isquémica epifisaria, Osteocondrosis, osteocondrosis (concepto no activo), necrosis epifisaria - RETIRADO - (concepto no activo), osteocondrosis, necrosis epifisaria - RETIRADO -
Japanese 骨端症, 骨端虚血性壊死, コッタンショウ, コッタンキョケツセイエシ
Czech Epifyzeální ischemická nekróza, Osteochondróza, osteochondróza
Russian KELERA BOLEZN', OSGUDA-SHLATTERA BOLEZN', ОСТЕОХОНДРОЗ, OSTEOKHONDROZ, КЕЛЕРА БОЛЕЗНЬ, ОСГУДА-ШЛАТТЕРА БОЛЕЗНЬ
Swedish Osteokondros
Polish Choroba Osgooda-Schlattera, Choroba Koehlera, Osteochondroza
Hungarian Epiphysis ischaemiás necrosisa, Osteochondrosis, Epiphysealis ischaemiás necrosis
Norwegian Osteokondrose