DDx
Diagnostic Considerations
The differential diagnosis of osteochondrosis includes the following entities:
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Chondroectodermal dysplasia
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Tubercular epiphysitis (In developing countries, tuberculosis of the hip is the most important differential diagnosis.)
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Dysplasia epiphysealis multiplex
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Type V physeal injuries
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Acute transient epiphysitis
Media Gallery
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Osteochondrosis of the lesser trochanter of the left femur (Monde-Felix disease). Image shows fragmentation.
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Perthes disease. Anteroposterior view of the pelvis and both hips. Image shows pathology involving the right hip joint. Also depicted is flattening, fragmentation, and sequestrum formation affecting the capital epiphysis of the femur, with metaphyseal cyst formation and osteopenia. Of note, no subluxation of the hip joint is observed.
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Osteochondrosis of the base of the fifth metatarsal bone (Iselin disease). Image shows fragmentation.
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MRI in the same patient as in image above shows altered marrow signal intensity in the apophysis of the fifth metatarsal base. This finding is suggestive of Iselin disease.
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Perthes disease. Lateral view of the same patient as in image above shows flattening of the epiphysis, as well as sclerosis with deformation of the femoral head.
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