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Osteochondroses
Arthur B. Meyers, MD; A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • > 70 entities, many with eponyms
          • Definitions

            • Collection of poorly understood "disorders" of immature skeleton
              • Term of limited utility given heterogeneity of entities
            • Many entities reflect symptomatic growth disturbances with elements of idiopathic osteonecrosis &/or overuse
            • Symptoms range from asymptomatic → pain → chronic manifestations of growth disturbances
            • Outcomes range from resolution of self-limited process → permanent deformity if untreated

          IMAGING

          • General Features

            • Radiographic Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      CLINICAL ISSUES

                      • Presentation

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Image Interpretation Pearls

                              Selected References

                              1. Launay F: Sports-related overuse injuries in children. Orthop Traumatol Surg Res. 101(1 Suppl):S139-47, 2015
                              2. Kim HK et al: Perfusion MRI in early stage of Legg-Calvé-Perthes disease to predict lateral pillar involvement: a preliminary study. J Bone Joint Surg Am. 96(14):1152-1160, 2014
                              3. Chang GH et al: Lower extremity overuse injuries in pediatric athletes: clinical presentation, imaging findings, and treatment. Clin Imaging. 37(5):836-46, 2013
                              4. Yoo WJ et al: Diffusion-weighted MRI reveals epiphyseal and metaphyseal abnormalities in Legg-Calvé-Perthes disease: a pilot study. Clin Orthop Relat Res. 469(10):2881-8, 2011
                              5. Davis KW: Imaging pediatric sports injuries: lower extremity. Radiol Clin North Am. 48(6):1213-35, 2010
                              6. Davis KW: Imaging pediatric sports injuries: upper extremity. Radiol Clin North Am. 48(6):1199-211, 2010
                              7. Doyle SM et al: Osteochondroses: a clinical review for the pediatrician. Curr Opin Pediatr. 22(1):41-6, 2010
                              8. Gillespie H: Osteochondroses and apophyseal injuries of the foot in the young athlete. Curr Sports Med Rep. 9(5):265-8, 2010
                              9. Ruchelsman DE et al: Osteochondritis dissecans of the capitellum: current concepts. J Am Acad Orthop Surg. 18(9):557-67, 2010
                              10. Carmont MR et al: Current concepts review: Freiberg's disease. Foot Ankle Int. 30(2):167-76, 2009
                              11. Dillman JR et al: MRI of Legg-Calve-Perthes disease. AJR Am J Roentgenol. 193(5):1394-407, 2009
                              12. Sabharwal S: Blount disease. J Bone Joint Surg Am. 91(7):1758-76, 2009
                              13. DiGiovanni CW et al: Osteonecrosis in the foot. J Am Acad Orthop Surg. 15(4):208-17, 2007
                              14. Kobayashi K et al: Lateral compression injuries in the pediatric elbow: Panner's disease and osteochondritis dissecans of the capitellum. J Am Acad Orthop Surg. 12(4):246-54, 2004
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Clinical Issues

                                    • Diagnostic Checklist

                                      TERMINOLOGY

                                      • Synonyms

                                        • > 70 entities, many with eponyms
                                      • Definitions

                                        • Collection of poorly understood "disorders" of immature skeleton
                                          • Term of limited utility given heterogeneity of entities
                                        • Many entities reflect symptomatic growth disturbances with elements of idiopathic osteonecrosis &/or overuse
                                        • Symptoms range from asymptomatic → pain → chronic manifestations of growth disturbances
                                        • Outcomes range from resolution of self-limited process → permanent deformity if untreated

                                      IMAGING

                                      • General Features

                                        • Radiographic Findings

                                          • MR Findings

                                            • Ultrasonographic Findings

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Natural History & Prognosis

                                                      • Treatment

                                                        DIAGNOSTIC CHECKLIST

                                                        • Image Interpretation Pearls

                                                          Selected References

                                                          1. Launay F: Sports-related overuse injuries in children. Orthop Traumatol Surg Res. 101(1 Suppl):S139-47, 2015
                                                          2. Kim HK et al: Perfusion MRI in early stage of Legg-Calvé-Perthes disease to predict lateral pillar involvement: a preliminary study. J Bone Joint Surg Am. 96(14):1152-1160, 2014
                                                          3. Chang GH et al: Lower extremity overuse injuries in pediatric athletes: clinical presentation, imaging findings, and treatment. Clin Imaging. 37(5):836-46, 2013
                                                          4. Yoo WJ et al: Diffusion-weighted MRI reveals epiphyseal and metaphyseal abnormalities in Legg-Calvé-Perthes disease: a pilot study. Clin Orthop Relat Res. 469(10):2881-8, 2011
                                                          5. Davis KW: Imaging pediatric sports injuries: lower extremity. Radiol Clin North Am. 48(6):1213-35, 2010
                                                          6. Davis KW: Imaging pediatric sports injuries: upper extremity. Radiol Clin North Am. 48(6):1199-211, 2010
                                                          7. Doyle SM et al: Osteochondroses: a clinical review for the pediatrician. Curr Opin Pediatr. 22(1):41-6, 2010
                                                          8. Gillespie H: Osteochondroses and apophyseal injuries of the foot in the young athlete. Curr Sports Med Rep. 9(5):265-8, 2010
                                                          9. Ruchelsman DE et al: Osteochondritis dissecans of the capitellum: current concepts. J Am Acad Orthop Surg. 18(9):557-67, 2010
                                                          10. Carmont MR et al: Current concepts review: Freiberg's disease. Foot Ankle Int. 30(2):167-76, 2009
                                                          11. Dillman JR et al: MRI of Legg-Calve-Perthes disease. AJR Am J Roentgenol. 193(5):1394-407, 2009
                                                          12. Sabharwal S: Blount disease. J Bone Joint Surg Am. 91(7):1758-76, 2009
                                                          13. DiGiovanni CW et al: Osteonecrosis in the foot. J Am Acad Orthop Surg. 15(4):208-17, 2007
                                                          14. Kobayashi K et al: Lateral compression injuries in the pediatric elbow: Panner's disease and osteochondritis dissecans of the capitellum. J Am Acad Orthop Surg. 12(4):246-54, 2004