These aspectic bone necroses are present in childhood | Aseptic bone necrosis

These aspectic bone necroses are present in childhood

Torso: Scheuermann’s disease (spinal column) Arms: Panner’s disease (elbows, humerus) Legs Hip: Perthes disease (necrosis of the femoral head) Knee: Osgood-Schlatter disease (tibial head), Sinding-Larsen disease (kneecap), Blount disease (tibial head) Foot: Talus necrosis, I disease (scaphoid), II disease (metatarsus), Apophysitis calcanei

  • Torso: Scheuermann’s disease (spinal column)
  • Arms: Panner disease (elbow, humerus)
  • Legs: Hip: Perthes disease (femoral head necrosis) Knee: Osgood-Schlatter disease (tibial head), Sinding-Larsen disease (patella), Blount disease (tibial head) Foot: Talus necrosis, I disease (scaphoid), II disease (metatarsus), Apophysitis calcanei
  • Hip: Perthes disease (necrosis of the femoral head)
  • Knee:Osgood-Schlatter’s disease (tibial plateau), Sinding-Larsen’s disease (kneecap), Blount’s disease (tibial plateau)
  • Foot: Talus necrosis,’s disease I (scaphoid),’s disease II (midfoot), Apophysitis calcanei
  • Hip: Perthes disease (necrosis of the femoral head)
  • Knee:Osgood-Schlatter’s disease (tibial plateau), Sinding-Larsen’s disease (kneecap), Blount’s disease (tibial plateau)
  • Foot: Talus necrosis,’s disease I (scaphoid),’s disease II (midfoot), Apophysitis calcanei

These aspectic bone necroses are present in adulthood

Lunatum necrosis (‘s disease) Renander’s disease (big toe sesamoid bone) Bone necrosis in the jaw’s disease (knee joint)

  • Lunatum necrosis (‘s disease)
  • Renander’s disease (great toe sesamoid bone)
  • Bone necrosis in the jaw

-‘s disease (knee joint)

You can recognize aseptic bone necrosis from these symptoms

Aseptic bone necroses are treacherous in their symptomatology, as they do not manifest themselves through characteristic symptoms. Thus the onset of bone necrosis is usually very inconspicuous. Precisely because there is no infectious cause of the necrosis, there are no strong symptoms such as pain or swelling.

Instead, the affected bones repeatedly experience slight pain over the course of time. This usually develops over time and initially tends to occur under stress. Only very rarely does pain in aseptic bone necrosis occur suddenly.

From a certain stage on, the pain typically occurs at rest and becomes even worse under stress. Later on, movement of the adjacent joints is usually additionally restricted. In advanced stages, the bone can become unstable and break due to the necrosis.

Due to the small amount of bone material, healing of the fracture is usually very difficult and lengthy. Consequential complaints that only occur after years are diseases such as arthrosis. Special attention should be paid to small children.

With them the symptoms can appear in a different order. For example, they are often conspicuous by a lack of joint mobility or by pain. The talus connects the heel bone (calcaneus) with the tibia and fibula (tibia and fibula) and thus forms the transition between the foot and the leg.

Necroses in this area are rather rare. Vascular changes are often the cause. Injuries are usually not the cause of aseptic bone necrosis of the talus.

The therapy of talus necrosis consists of relief as well as elimination of the causes. In most cases a conservative therapy with immobilization is sufficient, rarely an operation is necessary to treat e.g. malpositions and fractures. Aseptic bone necrosis in the metatarsus is also called II or-Freiberg disease.

Most frequently, girls in puberty, i.e. between the ages of 12 and 18, are affected by the disease. Due to the more frequent occurrence in girls, walking in high shoes is discussed as a possible trigger, but an exact cause is not known. It is probably an interplay of insufficient vascular supply, poor posture and growth.

If the bone necrosis cannot be stopped by relieving the strain, surgical therapy is usually necessary to stop the process. Acetabular necrosis, also known as Perthes disease, is a disease that occurs predominantly in childhood. The age peak of the disease is five to nine years, boys are more frequently affected than girls.

The main cause is suspected to be a vascular malformation of the femoral head. In addition, genetic factors as well as an increased stress situation and the hormone balance also play a role. Acetabular necrosis is one of the most common aseptic bone necrosis and typically manifests itself through hip or knee pain as well as restricted mobility in the hip.

During the course of the disease, changes occur both in the femoral head and later in the acetabulum. This leads to deformations of both parts of the joint, which, without therapy, can result in consequential damage such as osteoarthritis at a young age. The necrosis of the femoral head can usually be diagnosed with the help of an X-ray, and ultrasound of the hip can also provide initial indications of the disease.

Since the hip is a heavily loaded joint, surgery is usually necessary. The pelvic bones and the thigh bone are cut through. Only in this way can a normal positioning of the joint parts be achieved again.

However, even after the Perthes disease has healed, there is still an increased risk of arthrosis. Osgood-Schlatter’s disease describes an aseptic bone necrosis of the tibial plateau. The necrosis is located exactly at the point where the patellar tendon (patellar tendon) has grown into the head of the tibia.

Increased stress on the patellar tendon causes small pieces of bone to detach from the head of the tibia. As a result, they are no longer sufficiently supplied with nutrients and die. The consequences are bone necrosis and irritation of the surrounding tissue by the dead bone parts.

Typically, this disease occurs during puberty. It mainly affects young people who are active in sports. Due to the earlier onset of puberty, girls are usually affected somewhat earlier than boys.

In about a quarter to half of the affected girls, changes occur in both legs, but these usually start one after the other. The diagnosis can usually be made on the basis of the symptoms alone, but in order to rule out other injuries, an x-ray and an MRI scan are often taken in addition. The therapy of Osgood-Schlatter’s disease consists of a long sports break of up to several months.

The chances of recovery are very good if the disease is detected early and the patient takes a consistent break from exercise. However, in some cases, so-called ossicles, small bone corpuscles form within the patellar tendon, which have to be surgically removed in case of complaints. Apophysitis calcanei is a disease of the heel bone (Os calcaneus).

In apophysitis, the Achilles tendon attaches to the calcaneus and becomes ossified. This typically occurs in children in whom the apophysis (i.e. this attachment point) is strongly irritated, for example by shoes that are too small. Due to the strong irritation, the body feels the need to strengthen the tendon.

In children, the bone still has enough growth energy to transfer it to the tendon. For the therapy of the disease it is usually sufficient to relieve the affected heel. It may be necessary to remove ossified parts, but this should only be done after growth has been completed.

Morbus Sinding Larsen describes the aseptic bone necrosis at the tip of the kneecap (patella). Due to a high load on the knee during puberty, the point of attachment of the patellar tendon at the patella is irritated. Similar to Osgood-Schlatter’s disease, small pieces of bone can detach from the patella and migrate into the patellar tendon.

There they ossify and may cause problems. Sinding Larsen disease is usually treated conservatively, i.e. with a break from sport, painkillers and cooling of the affected knee. Seldom is a surgical intervention necessary to remove the bone fragments that have migrated into the area.

Panner’s disease is an aseptic bone necrosis of the elbow. The upper arm bone is affected. It typically occurs in children and adolescents and is due to insufficient blood supply to the bone.

Symptoms include stiffness of the affected elbow joint and pain that improves at rest and worsens under stress. Normally, Panner’s disease begins insidiously and lasts for several years. Normally, avoiding stress (e.g. throwing sports) is sufficient as therapy, occasionally the arm has to be immobilised with a splint for a few weeks.

In’s disease, the so-called lower-middle femoral epiphysis is affected by bone necrosis. The epiphysis is the growth plate, in the femur it is the thigh bone. ‘s disease therefore affects the growth plate of the femur in the area of the knee joint.

The aseptic bone necrosis occurs in the area of the knee, which points inwards. Here too, processes such as growth, hormonal fluctuations and changes in blood flow are the causes of the disease. ‘s disease is an aseptic bone necrosis of the os lunatum, the so-called lunar bone.

This bone is located in the wrist and is one of the carpal bones. A common cause of lunate necrosis is falls that are caught with the hands. In adults, the reason can also be work with a jackhammer, for example.

Even without a broken bone, this can lead to so-called micro-trauma. In this case the bone is only minimally injured, but the blood circulation is no longer completely guaranteed afterwards. This is why the bone tissue dies and the os lunatum necrosis occurs.

In Renander’s disease the so-called sesamoid bone of the big toe is affected by aseptic bone necrosis. The sesamoid bone is located underneath the big toe and serves there as a deflection point for the muscle that moves the big toe. Since the big toe plays an important role in running, the sesamoid bone is overstressed, especially in running sports, which can lead to bone necrosis.

The therapy of Renander’s disease consists primarily of sparing and avoiding high running loads. An operation is not necessary in most cases. ‘s disease is divided into’s disease I and II.

Type II is an aseptic bone necrosis of the metatarsal bones. In’s disease I, the scaphoid bone of the foot is affected. Due to reduced blood circulation, for example after trauma, the bone cells die off.

This causes mainly load-dependent pain in the area of the metatarsus. Children are typically affected by this disease. The therapy usually consists of painkillers and a relief of the affected foot.

Aseptic bone necrosis in the jaw is often due to the drug group of bisphosphonates. These inhibit the osteoclasts, i.e. cells involved in bone resorption, and should thus contribute to a more stable bone structure. However, studies have shown that etidronate, alendronate and risedronate are associated with an increased risk of aseptic bone necrosis in the jaw.

As these preparations are given to women in the menopause (cessation of menstruation) for osteoporosis (bone resorption), women aged 50 to 60 are often affected. ‘s disease describes aseptic bone necrosis of the knee joint. It is located in the medial (inner) part of the knee joint and is located there on the thigh bone.

As a rule, women over 60 years of age are affected. This group of people is most affected by osteoporosis (bone resorption in old age) due to hormonal changes, which is why a connection between’s disease and the hormonal changes is suspected. A good therapeutic option has not yet been discovered.

One usually starts with an analgesic and anti-inflammatory therapy. If this is not sufficient, a knee prosthesis is usually inserted. In Blount’s disease, the knee joint is affected by aseptic bone necrosis.

The centre of the complaints is located at the medial (inner) joint surface of the knee. Here, the part of the tibia bone that forms the knee joint is affected by the necrosis. Blount’s disease often occurs at primary school age and usually affects both legs.

If young people are affected by the disease, however, usually only one leg is affected. Typically, children are noticed by bow legs and knee pain. Risk factors include overweight and overloading of the knee joints.

Morbus Perthes is a synonym for femoral head necrosis and a typical children’s disease. Due to circulatory disorders and changes in the hormone balance, bone necrosis (death of bone tissue) occurs in the femoral head. This leads primarily to pain in the hips and knee.

Since children are often affected at an age when they cannot yet express these symptoms, the first sign that is often noticeable is a limping child. Scheuermann’s disease is a disease of the spine that usually occurs during puberty. Incorrect bone formation leads to instability of the individual vertebrae.

These are so weakened by aseptic osteochondrosis (disease of the cartilage and bone) that they can collapse. This maldevelopment of the bones can lead to severe malpositioning of the spine and thus of the entire upper body. Typically, Scheuermann’s disease only occurs during the growth spurt in puberty.

The disease usually develops throughout pubertal growth, but its progression is also terminated at the end of the growth phase. The affected adolescents usually have few complaints, although a clear hump may be visible. Only with particularly pronounced clinical pictures can the deformation of the spine be so great that the internal organs are also affected.

If, for example, the thorax is severely reduced in size by Scheuermann’s disease, breathing problems may occur. In adulthood, ill people often suffer earlier from degenerative spinal diseases. A healthy lifestyle, which includes back-friendly physical activity and targeted development of the trunk musculature, serves as a preventive measure.