|ESSR 2019 / P-0098|
|Osteochondroses, a pictorial review.|
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 . 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 so, osteochondroses are primarily believed to be the result of traumatic and/or vascular injury [2,3]. Symptoms vary according to the affected site, the most common complaint being pain exacerbated with activity. Lesions are usually self-limiting and treated conservatively.
Imaging findings depend on the time of the study within the natural course of the disease. At an early stage, they may be recognized as sclerosis and edema of the involved segment. Bone fragmentation and collapse can be found in advanced stages, followed by healing where bone architecture is restored with variable reconstitution of the normal morphology.
This poster will provide a review of the current literature and illustrate the disease by location, with a discussion of its imaging features, as well as the typical clinical symptoms and prognosis.
Literature on this topic is fragmented because of the variety of locations that may be involved, each bearing a different eponym (Table 1). Since diagnosis typically depends on imaging confirmation, most osteochondroses carry the name of the individual who first described their radiographic appearance.
Conflicting terminologies and classifications are an additional source of significant confusion. The terms osteochondrosis, osteochondritis, and apophysitis are often used interchangeably, but the suffix -itis should be avoided as it is generally agreed that inflammation is not a characteristic feature of the primary lesions . Nevertheless, when a fissure or fracture in the overlying articular cartilage is present, the condition is nearly universally referred to as osteochondritis dissecans (OCD). Strictly defined, OCD is not primarily a disease process of the growth center, and it occurs in adults as well as in children. Only the juvenile form will be considered in this review.
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