OSTEOCHONDRITIS (osteochondritis; Greek osteon a bone + chondros a cartilage + - itis) — an inflammation subchondral department of an epiphysis of long bones and apophyses of short bones of a skeleton.
At the beginning of a radiology the term «osteochondritis» irrespective of an etiology designated one and all diseases proceeding with damage of a bone and joint cartilage of an epiphysis. Further began to refer only infectious inflammatory defeats to this group, at to-rykh process extended from a bone to a cartilage or upside-down (e.g., tuberculosis, epiphyseal osteomyelitis, syphilis, etc.). Abroad still carry a row to group O. various on an etiology and a pathogeny of diseases, such as Pertes's disease (see. Pertesa disease ), Kinbek's disease (see. Kinbeka disease ), a disease of Keniga (see. Keniga disease ).
The lake arises owing to specific (tuberculosis, inborn syphilis), is more rare than a purulent infection. Purulent O. can usually be observed at heavy septic arthritises or epiphyseal hematogenous osteomyelitis at children.
Pathoanatomical changes at O. come down to education in a subchondral zone of spongy substance of the inflammatory center, the cellular structure to-rogo depends on the nature of an infection. In the field of cellular infiltration the partial or full rassasyvaniye of bone plates is noted that can gradually lead to destruction of a bone. In the cartilaginous tissue adjacent to a zone of the inflammatory center of the small sizes, changes consist in loss by separate chondrocytes of ability to be painted by nuclear paints and in decrease in a basophilia of the main substance of a cartilage. At the extensive center of an inflammation in a cartilage considerable acellular sites appear, in to-rykh is absent a basophilia of the main substance; small jags of a cartilaginous plate are possible.
Allocate a syphilitic osteochondritis of Vegner — Korzuna (see. Syphilis ), and also O. at children of the first months of life with syphilitic changes in bones and the muscles surrounding them, Paro which received the name of a disease. Inflammatory process at a disease of Paro is not limited to a subchondral zone of an epiphysis, passes to a metaphysis and leads to sequestration of an epiphysis. In addition to bone changes, at such children find the inflammatory phenomena in the muscles which are attached to the affected joint. The disease is characterized by the sluggish paralysis of extremities having nothing in common with true paralysis and therefore is called. pseudoparalysis of Paro. Because of tension of the inflamed muscles of the movement in joints are limited and painful, extremities adopt the characteristic provision: hands inertly hang along a trunk or kzad are taken away that is especially noticeable when the child sits (fig., a); legs are tightened to a stomach (fig., b). The raised and released hand inertly falls on a bed, however the affected extremities are not paralyzed: the child feels the sharp pain leading to reflex movement of fingers.
Syphilitic O. at babies depending on a stage of a disease is characterized on rentgenol. to signs expansion of a zone of preliminary calcification, roughness of its contours, emergence zones of a cross strip of an osteoporosis, the centers of destruction are lower. At a disease of Paro sharp destructive changes lead to vnutrimetafizarny changes with department of an epiphysis.
Treatment The lake comes down to antibacterial therapy, an immobilization of the affected extremity, according to indications — to an operative measure. Features of treatment are defined by an etiology.
Forecast for life favorable. The forecast concerning recovery of function of the affected extremities depends on O.'s etiology, timeliness and adequacy of treatment.
Bibliography: Bashirova F. X. An etiology and a pathogeny of the cutting osteochondrosis, Ortop, and travmat., No. 3, page 68, 1972, bibliogr.; Bezprozvanny B. K. izubarchuk S. K. This histologic researches at a disease of Keniga, Vestn, rentgenol, and radio-gramophones., No. 2, page 37, 1962; Vinogradova T. P. Diagnosis of bone and joint pathology on biopsies, page 37, M., 1964; Reynberg S.A. Radiodiagnosis of diseases of bones and joints, book 1, page 259, book 2, page 299, M., 1964; Aegerter E. Kirkpatrick J. A. Orthopedic diseases, p. 326, 336, Philadelphia a. o., 1969; I n o u e A. o. The pathogenesis of Perthes' disease, J. Bone Jt Surg., v. 58-B, p. 453, 1976; N i x o n J. R. a. D o u g 1 s J. F. Bilateral slipping of the upper femoral epiphysis in end-stagerenal failure, ibid., v. 62-B, p. 18, 1980.
G. I. Lavrishcheva.