Osteochondrosis is a family of orthopedic diseases of the joint. They usually occur in children and adolescents and are characterized by interruption of the blood supply of a bone (in particular to the epiphysis) followed by localized bony necrosis, and regrowth of the bone later. This disorder is defined as a focal disturbance of endochondral ossification and is regarded as having a multifactorial etiology. By definition, osteochondrosis is an aseptic ischemic necrosis.
The ultimate cause for these conditions is unknown. Among the most commonly cited etiologic factors are rapid growth, heredity, trauma (as well as overuse), anatomic conformation, and dietary imbalances. Recent literature strongly supports failure of blood supply to growth cartilage as most likely cause for osteochondrosis.
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 patient to limp. The spinal form, Scheuermann's disease, may cause bending, or kyphosis of the upper spine, giving a hunchback appearance.
Osteochondrosis is a self-limiting developmental derangement of normal bone growth, primarily involving the centers of ossification in the epiphysis. The disease usually begins in childhood as a degenerative or necrotic condition.
Conditions affecting various sites have been crudely grouped together under the term osteochondrosis. This categorization is primarily based on the morphologic and evolutionary similarities of the involved sites, as seen on radiographs. In broad terms, osteochondroses are a heterogeneous group of unrelated lesions that share the following characteristics:
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), and 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)
Non-articular: This group includes Sever's disease (of the calcaneus, or heel), and Kienbock's disease of the hand, and other conditions not completely characteristic of the osteochondrosis, such as Osgood-Schlatter's disease (of the tibial tubercle) and Osteochondritis dissecans.
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