Osteochondropathy: treatment of necrosis of the bone tissue of different joints
The symptoms and treatment of different types of osteochondropathy
Osteochondropathy is aseptic (non-infectious) necrosis of bone tissue, caused by violation of local blood circulation and metabolism.
There are more than ten types of osteochondropathy, each of which has its own symptoms, course and resolution.
In most cases, osteochondropathy develop in children and adolescents up to 17 years. More often diagnosed in boys.
The most susceptible those parts of the musculoskeletal system that are experiencing the greatest load: the wrist, knee, hip and wrist.
The disease is quite rare. Among all diseases, it is only 2.5-3%. Recently, however, the proportion of patients with this disease has increased significantly.
It is associated with the intensive development of sport among children and adolescents and, as a consequence of increasing load on the musculoskeletal system.
Types of the disease
Depending on the place of development of the necrotic process distinguish 4 types of dissecans.
Necrosis of the epiphyses of tubular bones:
- heads II and III metatarsal bone;
- phalanges of the fingers;
- the head of the femur;
- varus curvature of the tibia.
The necrosis of the short spongy bones:
- the lunate bone;
- sesamoid bones of the metatarsophalangeal I joint;
- the navicular bone;
- of a vertebral body.
Osteochondropathy of apofiza:
- tuberosity of the calcaneus;
- the tuberosity of the tibia;
- rings of the vertebrae.
Partial necrosis of the surfaces of the joints:
- of the condyles of the femur;
- capitate elevation of the humerus.
Causes and risk factors
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The violation occurs because of a dysfunction of the local blood supply of bone tissue. Due to the fact that the blood cannot deliver to the tissues of micronutrients, they die, that is formed the bone necrosis. Then necrotic areas disintegrate.
Circulatory disorders – the main but not the only cause of the development of necrosis.
For example, there is still no consensus about the occurrence of the disease Calvet, which affects the vertebral body. It is believed that necrosis develops under the influence of eosinophilic granuloma. At least, the blood circulation is not observed.
Despite the fact that many of osteochondropathy unclear, doctors isolated a number of risk factors of formation of necrosis:
- male gender;
- genetic predisposition;
- disruptions in metabolism;
- neurotrophic disorders;
- use of corticosteroids;
- childhood and adolescence;
- improper diet or excessive dieting;
- endocrine pathology;
- irregularities in the connective tissue.
The more a person has risk factors, the higher the probability of occurrence of the disease.
The symptoms and treatment of the disease
Every kind of osteochondropathy has its clinical manifestations, and therefore requires a more detailed description. As many types of this disease are presented by individual cases, consider only the most common.
Non-infectious necrosis of the femoral head. Is characterized by the curvature of the neck and the femoral head that leads to the development of coxarthrosis.
Occurs usually in males in 5-10 years When this pathology is characterized by violation of gait, lameness, pain in the hip joint. Appears atrophy of the muscles moving the joint are limited.
Calm joint pain subsides or disappears. The treatment of the disease includes rest as well as stimulation of processes of bone tissue restoration physiotherapy and medication. In rare cases, surgery is carried out.
Necrosis of the epiphysis of the navicular bone of the foot
Disease Keller I is most often in boys 3-7 years. You’ll be tenderness in the area of the medial longitudinal arch, a limp.
The foot becomes swollen. The disease is diagnosed through radiographic studies. Treatment includes rest, wearing a plaster boot, physiotherapy, reducing the burden on the leg.
Necrosis of the metatarsal head
The illness of Keller II usually diagnosed in girls 10-15 years. Characterized by pain in the forefoot, gait disturbance, swelling. Sometimes hyperemia of the skin on the back of the foot.
Subsequently developing a shortening of 2 or 3 fingers. Patients is attributed to the complete rest and unloading of the affected foot. Assigned to physical therapy and vitamins.
Necrosis of a vertebral body
The disease often develops at the age of 5-7 years, most of the boys. The child begins to feel fatigue and back pain.
Visually you can clearly see the bulging necrotic spinous process of the vertebra, and on the x-ray – reducing its height to ¼ of normal.
Treatment involves rest, physiotherapy, exercises. The morphology and structure of the affected vertebra is restored in a few years.
Disease Osgood-Schlatter – osteochondropathy the tibial tuberosity. This condition prevails more often in boys 12-15 years. To symptoms include swelling and pain in the area of injury.
During the descent or climbing stairs, kneeling the pain increases.
In this work the joint is almost not disturbed. Treatment for this type osteochondropathy stationary.
The patient is recommended to limit the load on the leg, and if you often have pain applied a plaster lock for a few weeks.
Also prescribed vitamin therapy, applying paraffin, electrophoresis. In most cases the disease runs in 1.5-2 years.
Necrosis of the vertebrae epifizov
Disease Chairman-Mau one of the most common pathologies of the musculoskeletal system during adolescence. Back pain is almost not felt, but in the face of obvious kyphosis of the thoracic spine.
It becomes the reason for seeking medical attention. This kind of osteochondropathy accompanied by deformity of multiple vertebrae. To mitigate the impact, the patient is prescribed a complete rest.
Treatment is includes gymnastics, massage of the back muscles and abdomen. With timely detection of pathology, the outcome is favorable.
Osteochondropathy tuberosity of the calcaneus
Disease Since-Haglund quite rare pathology, which is revealed usually in the age 7-14 years. Is characterized by swelling and pain in the heel area.
The treatment provides thermal treatments, electrophoresis with calcium and limit the load on the leg.
Necrosis of the lunate bone
The main symptoms of Kinbaku include swelling on the back of the hand and pain in the wrist joint. The pain intensified as disease progression and movement.
As treatment immobilization – immobilization of the joint using a plastic or a plaster splint. Also credited with the patient mud therapy, procaine blockade, paraffin. In some cases, the surgery.
They include diseases Panera, Koenig, and others. In most cases, osteochondropathy develop in the knee joint.
Most often they are sick men up to 25 years. First on the convex surface of the joint develops necrosis, and then the affected area is separated from the healthy and turns into a «joint mouse».
All this is accompanied by painful sensations in the knee joint, limitation of motion and swelling.
At the initial stage of pathology development is shown conservative treatment: physical therapy, paraffin therapy, immobilization, rest.
If formed a «joint mouse» and there are frequent blockade of the joint, performed surgery, during which removed necrotic tissue.
Hands down not worth it
At first glance, the diagnosis of «osteochondropathy» sounds like a death sentence. However, do not be afraid of this disease. Firstly, it is found it is very rare.
Second, most types of aseptic necrosis has a favourable resolution. Of course, over time, you may experience complications such as arthritis or low back pain, but they pose little danger to human life.
The main thing that is required to combat this disease – great patience.
The disease develops very slowly and can take years to necrotic areas of the bone tissue was replaced by a new one. But if you adhere to correct treatment and lead a healthy lifestyle, the disease will depart.