are a family of orthopedic diseases
that occur in children and in rapidly growing animals, particularly pigs, horses, and dogs. They are characterized by interruption of the blood
supply of a bone, in particular to the epiphysis
, followed by localized bony necrosis
, and later, regrowth of the bone.
The ultimate cause for these conditions is unknown, although several of the human osteochrondroses are more common in very active individuals. This leads some researchers to speculate that cumulative microtrauma
may be the primary event.
Osteochondrosis in swine has been shown to be a condition responsive to supplementation with the essential trace element boron and may be a manifestation of boron deficiency.
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 victim to limp. The spinal form, Scheuermann's disease, may cause bending, or kyphosis
of the upper spine.
In humans, these conditions may be classified into three groups:
- Spinal: Scheuermann's disease (of the interspinal joints)
- 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 metatarsal of the foot; sometimes called Freiberg's Infarction or Freiberg's disease)
- Non-articular: This group includes Kienbock's disease (of the lunate bone of the wrist) and Sever's disease (of the calcaneus, or heel), and other conditions not completely characteristic of the osteochondrosis, such as Osgood-Schlatter's disease (of the tibial tubercle) and Osteochondritis dissecans.
The prognosis for these conditions is very variable, and depends both on the anatomic site and on the time at which it is detected. In some osteochondroses, such as Sever's disease and Freiberg's infraction, the involved bone may heal in a relatively normal shape and leave the patient asymptomatic. On the contrary, Legg-Calvé-Perthes disease frequently results in a deformed femoral head that leads to arthritis and the need for joint replacement. Surgery to correct this problem is long, and can be very painful.