osteochondroses

Question 1

osteochondroses

Answer 1

aka epiphysis, aseptic necrosis

the most susceptible areas are the epiphyses, which are entirely covered by articular cartilage and are poorly vascularized

Question 2

a disorder of one or more ossification sites with localized subchondral necrosis followed by recalcification

Answer 2

Osteochondritis Dissecans (OCD or OD)

Question 3

in OCD the subchondral bone and adjacent layer of articular cartilage ______ and ______ from the underlying bone.

Answer 3

separate and pull away

Question 4

what is the cause of OCD or OD

Answer 4

repetitive microtrauma resulting in ischemia and disruption of the subchondral growth

Question 5

what are symptoms of OD or OCD

Answer 5

activity related pain, swelling, and giving way

Wilson sign

Question 6

pain in increased with passive knee extension and tibial internal rotation and relived with tibial external rotaion

Answer 6

Wilson sign

Question 7

management of OCD

Answer 7

nonoperative:
- activity modification
- protected weight bearing
- immobilization of 4 - 6 weeks

surgery
- arthroscopic to fixate the lesion and debride tissues from the defect and implant tissues to stimulate healing

Question 8

what is the death of bone and bone marrow cellular component because of loss of blood supply in the absence of infection?

Answer 8

osteonecrosis

Question 9

what is the most common site for osteonecrosis

Answer 9

femoral head (chandler disease)

note: causes 10% of THA surgeries

Question 10

in ________ no symptoms are observed at first then the pain may be mild and ______ initially and progress to severe.

Answer 10

osteonecrosis

intermittent

Question 11

what surgical procedure is commonly used for osteonecrosis

Answer 11

core decompression
HHA (or other joint)
TKA (or other joint)

Question 12

what is Perthes Disease

Answer 12

flat hip and osteochondritis deformans juveniles

epiphyseal aseptic necrosis of the proximal femur characterized by avascular necrosis and ischemia

Legg-Calve-Perthes Disease

Question 13

what population is perthes diease most common

Answer 13

1 in 1200 children
5:1 ratio of boys:girls
usually ages 5-8

Question 14

T or F: children with perthes diease will experience complete revascularization of the area over a period without any treatment

Answer 14

True; just be cautious of deformation

Question 15

what disease results from patellar tendon fibers pulling small bits of immature bone from the tib tub

Answer 15

osgood-schlatter disease

Question 16

what population is primarily affected by osgood-schlatter disease

Answer 16

boys 10-15
girls 8-13
Boys:Girls 3:1

athletes and military recruits

Question 17

in osgood-schlatter disease some causes are indirect trauma, _______ traction, and _______ tibial torsion.

Answer 17

longitudinal
external

Question 18

pathogenesis of osgood-schlatter disease

Answer 18

• high riding patellar
• genu valgum or varum
• flatfooted children

Question 19

clinical manifestations of osgood-schlatter disease

Answer 19

• aching pain at tib tub
• aggravated by activity
  -swelling and heat and tenderness
• hammy tightness, IT tightness, triceps surae tightness