Osteochondrosis is a family of disorders that affects the growth of bones in children and adolescents. The disruption of blood flow to the joints is often the cause. Though certain diseases in this family can affect older adults, they’re most likely to affect children and teenagers whose bones are still growing.
Osteochondroses may cause pain and disability.
A number of diseases fall into the category of osteochondrosis. They affect different parts of the body. They’re typically grouped into one of three categories based on where they occur. They can be articular, physeal, or nonarticular.
Articular diseases
Articular diseases occur in joint areas and include:
• Legg-Calve-Perthes disease (affects the hip)
• Panner’s disease (affects the elbow)
• Frieberg’s disease/ infraction (affects the second toe)
• Köhler disease (affects the foot)
Legg-Calve-Perthes disease
Legg-Calve-Perthes disease occurs when the ball of the thigh bone in the hip does not get enough blood, causing the bone to die. Legg-Calve-Perthes disease usually occurs in boys 4 through 10 years old. There are many theories about the cause of this disease, but little is actually known. Without enough blood to the area, the bone dies. The ball of the hip collapses and becomes flat. Most often, only one hip is affected, although it can occur on both sides.
The blood supply returns over several months, bringing in new bone cells. The new cells gradually replace the dead bone over 2 to 3 years. The first symptom is often limping, which is usually painless, although sometimes patients experience mild pain.
Other symptoms may include:
• Hip stiffness that limits hip movement
• Knee pain
• Limited range of motion
• Thigh or groin pain
• Shortening of the leg, legs of unequal length
• Muscle loss in the upper thigh
Panner's disease
Although it is called a 'disease,' Panner's disease is really a rare but painful bone condition that is linked to overuse of the elbow. Even though recovery can be slow, kids with Panner's disease usually suffer from no long-term problems as a result of the condition. Panner's disease involves the growth plate in the elbow (growth plates produce new bone tissue and determine the final length and shape of bones in adulthood). The disease occurs in kids who are younger than age 10, typically young athletes, and usually affects the dominant arm.
Panner's disease is part of a family of bone development diseases (known as osteochondroses, or in singular form, osteochondrosis) that occurs in kids and teens. In osteochondrosis, something temporarily disrupts the blood supply to an area of developing bone. When the tissues in the bone do not get enough blood, they begin to die (a process known as necrosis). This leads to deterioration of the bone's growth plate, the area at the end of a developing bone where cartilage cells change over time into bone cells.
When bone development occurs normally, the growth plates expand and unite, which is how bones grow. However, osteochondrosis disrupts this process, leading to cell death and destruction of the newly formed tissue. Although the bone tissue regrows, the process can cause temporary problems in the affected area. Osteochondrosis can affect different areas of the body that have growth plates.
Some doctors believe that Panner's disease is a precursor to a separate but similar condition called osteochondritis dissecans of the capitellum (OCD), which occurs in older kids. OCD is different from Panner's disease because it doesn't involve the growth plate. By the time OCD occurs, the growth plates have fused and the skeleton has finished growing. In OCD, loose bone fragments (also called loose bodies) may develop in the joint as well.
Frieberg’s disease
In its juvenile osteochondrosis form, Freiberg disease is a degenerative process involving the epiphyses resulting in osteonecrosis of subchondral cancellous bone. If the process is altered in such a way as to restore normal physiology, this may be followed by regeneration or recalcification. If not, the process continues to subchondral collapse and eventual fragmentation of the joint surface.
Köhler disease
In this uncommon condition, children present with an antalgic limp and local tenderness of the medial aspect of the foot over the navicula. The child can walk with an increased weight on the lateral side of the foot. Frequently, there is swelling and redness of the soft tissues.
Köhler diseaseis a rare bone disorder of the foot found in children between six and nine years of age. The disease typically affects boys, but it can also affect girls. It was first described in 1908 by Alban Köhler (1874–1947), a German radiologist.
It is caused when the navicular bone temporarily loses its blood supply. As a result, tissue in the bone dies and the bone collapses. When treated, it causes no long term problems in most cases although rarely can return in adults. As the navicular bone gets back to normal, symptoms typically abate.
Sufferers experience pain and swelling in the middle part of the foot and usually limp as a result. Patients that walk with a limp tend to walk with increased weight on the lateral side of the foot. Also, there can be tenderness over the navicular. Patients often complain of pain over the apex. An X-ray of both feet is used to diagnose disease. The affected foot tends to have a sclerotic and flattened navicular bone.
Physeal disease
The main physeal disease is Scheuermann's disease, or juvenile kyphosis. This condition affects the intervertebral joints of the spinal column. These are the joints between the bones of your spine.
Nonarticular disease
Nonarticular diseases can affect any part of your skeleton. The most common nonarticular disease is Osgood-Schlatter disease, which affects the knee. Osgood-Schlatter disease causes irritation of the growth plate in the area of the tibial tuberosity, which is the top part of your shinbone, right under your knee. Sever’s disease, which affects the heel, is another type of nonarticular osteochondrosis.
Osteochondritis dissecans
Osteochondritis dissecans is another form of osteochondrosis. It occurs when small pieces of cartilage and bone become dislodged in the joint due to a lack of blood flow. This can occur in any part of the body and is most common in the knee.
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