Osteochondroses Clinical Presentation

Updated: Dec 12, 2017
  • Author: Manish Kumar Varshney, MBBS, MRCS; Chief Editor: Harris Gellman, MD  more...
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Presentation

History and Physical Examination

The presentation and findings of patients with osteochondrosis depend on the site of involvement and on the stage to which the syndrome has progressed.

Pain that is localized to the affected site is usually present in the initial stages (eg, pain during kneeling in patients with Osgood-Schlatter disease or referred pain to the knee in those with Perthes disease). However, clinicians should remember that patients are asymptomatic more often than not and that they typically present late, after the onset of disability. Nonspecific bone and joint pains that occur in children during growth spurts are often overlooked, and many of these may reflect osteochondroses.

Findings commonly found alone or in combination include the following:

  • Localized tenderness
  • Limited movement of adjacent joints
  • Swelling
  • Gait disturbance (when the disease affects the lower limbs)
  • Reactive effusion in an adjacent joint (sometimes observed)

Growth disturbance and secondary deformities are late presentations in specific entities, such as Blount disease (shortening and tibia vara), Scheuermann disease (kyphosis), and Perthes disease (shortening and coxa vara, magna, or brevis).

Of greatest importance is that systemic symptoms of inflammation (eg, fever, malaise, weight loss, local redness, and raised temperature) should alert physicians to search for causes other than an osteochondrosis.