Eight male and three female patients were identified, including four who underwent
epiphyseal transfer.
The precise anatomic sites of lesions (diaphyseal, metaphyseal, or
epiphyseal and intramedullary versus cortical or periosteal) also require consideration.
The pathogenesis of rickets involves impaired mineralization of physeal and
epiphyseal cartilage during endochondral ossification and newly formed osteoid (McCarthy and Frassica, 1998).
SONK Atraumatic osteonecrosis Synonyms Primary necrosis, Secondary, idiopathic osteonecrosis osteonecrosis Age group Older patients, usually Younger patients, > 55 years usually < 55 years Patient Elderly female, with Young active profile moderate OA Presentation Acute Insidious onset and pain/acute-on-chronic slow progression pain Risk factors None Steroid/ethanol use, renal disease Joints Weight-bearing, usually Non-weight-bearing, involved unilateral commonly bilateral Location of
Epiphyseal to Diaphyseal, bone subchondral surface metaphyseal, involvement
epiphyseal T2-weighted Increased signal at Decreased signal at MRI margin, decreased signal margin with increased at centre of lesion signal of inner border - double-line sign
A diaphyseal (midshaft) fracture in a child less than 3 years old is suspect, and metaphysical or
epiphyseal fractures beyond the newborn period (also called corner fractures or bucket handle fractures) are virtually diagnostic of abuse.
Harris (1) described an
epiphyseal centre in the pisiform bones of sub-human primates and its implications on whether the pisiform should be considered as a sesamoid bone.
In adolescents who present with hip pain, the differential includes infectious etiologies (eg, septic arthritis, osteomyelitis), tumors, and traumatic injuries (eg, contusions, fractures,
epiphyseal injuries).
Radiography of the left hand revealed a lytic expansile
epiphyseal lesion in the head of the ring finger metacarpal bone.
Papers on tooth eruption and wear are also in a separate section, and other general topics include applications of osteometrics and
epiphyseal fusion and sexual dimorphism.
Fracture extension into the
epiphyseal plate is another potential risk of OSD, although it only occurs rarely.
FOUR-year-old Jack Bannister is a child in two million - one of a handful who suffer Spondylo
Epiphyseal Displasia congentia.
All of these featu res were consistent with a very narrow range of differential diagnoses, of which SED congenita was the most likely, followed by multiple
epiphyseal dysplasia and type IV mucopolysaccharidosis (Morquio's syndrome).