Learning objectives
Provide a pictorial review of the various osteochondroses.
Describe their multimodality imaging findings.
Summarize their pathophysiological and clinical features.
Background
Osteochondroses are an important source of morbidity in children and adolescents.
They comprise an inhomogeneous group of seemingly unrelated lesions that result from a focal disturbance in the developing epiphyseal cartilage [1].
Endochondral ossification is a growth mechanism present in the epiphyses and epiphyseal equivalents such as apophyses,
and almost all of them can be affected.
Despite increasing recognition of this disease,
its pathogenesis is incompletely understood.
The etiology appears to be multifactorial,
with no single factor accounting for all aspects of the disease.
Even...
Imaging findings OR Procedure Details
Scheuermann disease
Scheuermann disease is the most common form of thoracic kyphosis in adolescence [5].
It is considered an osteochondrosis affecting the vertebral epiphyseal growth plates.
When the ring apophysis becomes avascular,
there is inhibited endochondral ossification with resulting endplate perforations and intravertebral disc herniations.
Etiology is unknown,
but it is thought to have a familial predisposition with a dominant autosomal pattern of inheritance.
Repetitive axial loading activity also poses as a biomechanical stress factor in the immature spine [6,7].
Compressive forces cause wedging deformity...
Conclusion
Osteochondrosis is a disturbance of endochondral ossification that has been documented in various epiphyses and epiphyseal equivalents.
The exact pathogenesis is not yet completely understood,
the most accepted causative factors being vascular and overuse injuries because of repetitive microtrauma to the immature skeleton.
Symptoms vary according to the affected site,
but mostly involve pain that exacerbates with physical activity.
Cases generally have a self-limiting course,
with a good overall prognosis.
Non-operative conservative treatment is typically recommended,
consisting of nonsteroidal anti-inflammatory drugs,
physical therapy,
ice,
and...
References
Siffert RS.
Classification of the osteochondroses.
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1981;(158):10-18.
Gillespie H.
Osteochondroses and apophyseal injuries of the foot in the young athlete.
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Edmonds EW,
Heyworth BE.
Osteochondritis dissecans of the shoulder and hip.
Clin Sports Med.
2014;33(2):285-294.
Edmonds EW,
Polousky J.
A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from König to the ROCK study group.
Clin Orthop Relat Res.
2013;471(4):1118-1126.
Scheuermann H.
Kyphosis dorsalis juvenilis.
Orthop Chir.
1921;41:305.
Doyle SM,
Monahan A.
Osteochondroses:...