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    Disorders of Epiphyses and Epiphyseal Growth - IGN

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    Wiguna
    This document discusses disorders of epiphyses and epiphyseal growth plates. It covers generalized and localized disorders, including conditions like Achondroplasia and Rickets. The nutrition and blood supply of the epiphysis is described. Avascular necrosis and idiopathic avascular necrosis (osteochondrosis) are explained. Features of osteochondrosis like incidence, pathogenesis, phases, clinical presentation and treatment aims/principles are summarized.

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    Disorders of Epiphyses and Epiphyseal Growth - IGN

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    Wiguna
    46 views11 pages
    This document discusses disorders of epiphyses and epiphyseal growth plates. It covers generalized and localized disorders, including conditions like Achondroplasia and Rickets. The nutrition and blood supply of the epiphysis is described. Avascular necrosis and idiopathic avascular necrosis (osteochondrosis) are explained. Features of osteochondrosis like incidence, pathogenesis, phases, clinical presentation and treatment aims/principles are summarized.

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    This document discusses disorders of epiphyses and epiphyseal growth plates. It covers generalized and localized disorders, including conditions like Achondroplasia and Rickets. The nutrition and blood supply of the epiphysis is described. Avascular necrosis and idiopathic avascular necrosis (osteochondrosis) are explained. Features of osteochondrosis like incidence, pathogenesis, phases, clinical presentation and treatment aims/principles are summarized.

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    46 views11 pages

    Disorders of Epiphyses and Epiphyseal Growth - IGN

    Uploaded by

    Wiguna
    This document discusses disorders of epiphyses and epiphyseal growth plates. It covers generalized and localized disorders, including conditions like Achondroplasia and Rickets. The nutrition and blood supply of the epiphysis is described. Avascular necrosis and idiopathic avascular necrosis (osteochondrosis) are explained. Features of osteochondrosis like incidence, pathogenesis, phases, clinical presentation and treatment aims/principles are summarized.

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    Disorders of

    Epiphyses and
    Epiphyseal Growth
    Disorders of Epiphysis and
    Epiphyseal Plates:
    • Generalized
    • Congenital (ex. Achondroplasia)
    • Acquired (ex. Rickets)
    • Localized
    • Pressure type (Leg-Calve-Perthes Disease)
    • Traction type (ex. Tibial tubercle / Osgood-
    Schlatter Disease)
    • Osteochondrosis: an idiopathic type of
    avascular necrosis.
    Nutrition of The Epiphysis and
    Its Epiphyseal Plate
    • Most pressure epiphysis are
    covered essentially by articular
    cartilage and receive blood
    vessels only from their bare
    bone area.
    • Femoral head, being completely
    intraarticular, and completely
    covered by articular cartilage so
    the blood supply precariously
    must penetrate the cartilage
    clothing.
    • Disruption of ephypiseal blood
    vessels leads to ischemia of
    epiphyseal plate and growth
    disturbance.
    Avascular Necrosis of Bone
    • Series of pathological events from the
    initial loss of blood supply and resultant
    death of bone to the gradual replacement
    of the dead bone by living bone.
    • Etiology:
    • Genetically determined vascular configuration.
    • Trauma
    • Tense synovial effusion.
    Idiopathic Avascular Necrosis of
    Epiphyses (Osteochondroses)
    • Synonims: Epiphysitis, Osteochondrosis,
    Aseptic Necrosis, Ischemic Epiphyseal
    Necrosis  confusing.
    • Kohler Disease, Osgood Schlatter Disease,
    Leg-Calve-Perthes Disease  more
    confusing.
    • The etiology is similar in every entities.
    General Feature of
    Osteochondroses
    • Incident and Etiology
    • Most common: 3-10 years old
    • Boys > girls
    • Lower limbs > upper limbs
    • Pathogenesis and Pathology
    • Osteochondroses is a self-limiting disease, with or
    without treatment.
    • Phases:
    • Early Phase of Necrosis
    • Phase of Revascularization with Bone Deposition and
    Resorption
    • Phase of Bone Healing
    • Phase of Residual Deformity
    Clinical Feature and Diagnosis
    • Quiet-early phase of necroses, osteochondroses produce
    neither symptomps nor clinical signs.
    • Revascularization phase, if a pathological fracture develops in
    the subchondral bone, the pain will appear.
    • Synovial effusion develops causing local tenderness and
    painful limitation of motion in the joint, especially in
    abduction.
    • If left untreated, symtomps and sign will be intermitten,
    causing disuse atrophy of involved muscle.
    • Differential diagnosis:
    • Irregular ossification in normal epiphysis.
    • Generalized disorders suc as hypothyroidism and epiphyseal
    dysplasia.
    Sequelae
    • Subchondral fracture in the epiphysis
    • Subluxation of the involved joint
    • Deformity of epiphysis with resultant joint
    incongruity
    • Secondary degenerative joint disease.
    Aim and Principles of Treatment
    • The aims of treatments:
    • Prevent the epiphyseal deformity.
    • Preserve the congruity of joint to prevent secondary
    osteoarthritis.
    • The principles of treatment:
    • Prevention of abnormal forces on the epiphysis during
    the vulnerable phase of revascularization and healing.

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