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[osteo- + chondrosis]
A disease causing painful endochondral ossification in the epiphyses bones and nearby ossification centers.
It typically affects young athletes between the ages of 10 and 15, and, depending on the individuals and the activities in which they engage, may affect one or more joints.
Blount disease is osteochondrosis of the tibia; Freiberg infraction involves the foot; Iselin disease, the base of the fifth metatarsal bone; Kienbock disease, the wrist; Kohler, the foot; Legg-Calve-Perthes disease, the hip joint; Monde-Felix disease, the lesser trochanter of the femur; Osgood-Schlatter disease, the patella; Panner disease, the medial epicondyle; Scheuermann disease, the thoracic spine; Sever disease, the heel; Sinding-Larsen-Johanssen, the anterior knee; Van Neck disease, the ischiopubic synchondrosis.
Although the precise cause or causes of osteochondrosis is unknown, the disease has an inherited component, and typically occurs in young, physically active people, esp. those who overuse or repeatedly traumatize a region of the body in a specialized sport. Regional blood flow to the affected joint is impaired.
SYMPTOMS AND SIGNS
The patient experiences constant aching pain and tenderness over the affected joint, which worsens with activity. Soft-tissue swelling, limping, and/or localized heat and tenderness may be present.
Diagnosis is based on clinical examination, x-ray studies revealing bony sclerosis, and bone scans or magnetic resonance imaging.
IMPACT ON HEALTH
Osteochondrosis (except for Legg-Calve-Perthes disease) usually resolves spontaneously over time. However, the course may be protracted, and it is still difficult to predict who will respond rapidly or completely, who may need a prolonged course of rest, who may develop arthrosis, or who will need surgery.
Many patients respond favorably to conservative treatment: rest, icing of sore joints, splinting or casting, corticosteroid injections, or physical therapy. Surgery may be used on an individualized basis for people with difficult to manage disease.
Since the disease usually is self-limiting; treatment is conservative, supportive, and palliative. Bedrest is encouraged, and support is offered through disruption of normal activity. The affected joint may be immobilized in extension for 6 to 8 weeks if necessary. The patient learns the correct use of crutches, splints, casts, and the importance of limitation of activity. Neurocirculatory function distal to supportive devices (splint, elastic support, or cast) is evaluated. Joint mobility and limitation of motion are assessed daily. If conservative treatment is ineffective (which is rare), the orthopedic surgeon removes or fixates the epiphysis or operates to improve revascularization and resolution of pain.