The term osteochondroses refers to a group of diseases of children and
adolescents in which localized tissue death (necrosis) occurs, usually
followed by full regeneration of healthy bone tissue. The singular term is
During the years of rapid bone growth, blood supply to the growing ends of
bones (epiphyses) may become insufficient resulting in necrotic bone,
usually near joints. Since bone is normally undergoing a continuous
rebuilding process, the necrotic areas are most often self-repaired over a
period of weeks or months.
Osteochondrosis can affect different areas of the body and is often
categorized by one of three locations: articular, non-articular, and
Physeal osteochondrosis is known as Scheuermann disease or juvenile
kyphosis. It is a deformity of the thoracic spine (in the chest area, the
vertebra to which ribs are attached) caused by abnormal centers of bone
development at the intervertebral joints (physes). It is most common among
children ages 13 to 16.
Articular disease occurs at the joints (articulations). One of the more
common forms is Legg-Calvé-Perthes disease, which occurs at the hip
joint. Other forms include Köhler disease (foot), Freiberg disease
(second toe), and Panner disease (elbow). These diseases are most common
, although they have been found in individuals ranging in age from eight
Non-articular osteochondrosis occurs at any other skeletal location. For
instance, Osgood-Schlatter disease of the tibia (the large inner bone of
the leg between the knee and ankle) is relatively common. It is often the
cause of knee and leg
in active teens.
Osteochondritis dissecans (OCD) is a form of osteochondrosis in which
loose bone fragments form in a joint. The knee is a common site for
osteochondritis dissecans. The condition is found most often in people
aged ten to 20, although it may occur at other ages. OCD is sometimes
associated with some sort of past trauma to the joint. In about 30 to 40
percent of cases the same joint on both sides of the body is involved
(e.g. both knees, both elbows).
Osteochondroses are disorders of teens and young adults. Some are rare
disorders, and in many cases, the number of individuals who have these
disorders is not known, since cases many resolve on their own. Scheuermann
disease is thought to occur in 0.4 to 8 percent of individuals. One
Finnish study found that 13 percent of adolescents had Osgood-Schlatter
disease. Freiberg disease is the one type of osteochondrosis that is more
common in females than in males. OCD affects males about twice as often as
females. All other osteochondrosis appear to affect the sexes equally.
Causes and symptoms
Many theories have been advanced to account for osteochondrosis, but none
has proven fully satisfactory. Stress on the bone, ischemia (reduced blood
supply), and trauma to the site are commonly mentioned factors. Athletic
children are often affected when they overstress their developing limbs
with a particular repetitive motion. Many cases are idiopathic, meaning
that no specific cause is known.
The most common symptom for most types of osteochondrosis is pain, usually
a dull, non-specific ache, at the affected joint. Pain is especially
noticeable when pressure is applied. Locking of a joint or limited range
of motion at a joint can also occur.
Scheuermann disease can (rarely) lead to serious kyphosis (hunchback
condition) due to erosion of the vertebral bodies. Usually, however, the
kyphosis is mild, causing no further symptoms and requiring no special
A doctor should be consulted whenever a child has a persistent joint pain
that does not go away after resting the joint for a few days.
Diagnosis is suspected based on history and symptoms. It can be confirmed
by x-ray findings.
Conservative treatment is usually attempted first. In many cases, resting
the affected body part for a several days or weeks brings relief. A cast
may be applied if needed to prevent movement of a joint.
Surgical intervention may be needed in some cases of osteochondritis
dissecans to remove abnormal bone fragments in a joint. Rarely is spine
curvature so pronounced in Scheuermann disease that the individual needs
to wear a brace or have surgical intervention.
Accurate prediction of the outcome for individual adolescents is difficult
with osteochondrosis. Some individuals heal spontaneously. Others heal
with little treatment
other than keeping weight or stress off the affected limb. The earlier
the age of onset, the better the prospects for full recovery. Surgical
intervention is often successful in osteochondritis dissecans.
No preventive measures are known.
—A bone-building cell.
—A large, multinuclear cell involved in the physiological
destruction and absorption of bone.
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