الفهرس 
DiagnosisOnly 14 pages are availabe for public view
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Abstract
Osteoohondroses repCBsents.group of epiphyseal disorders
that 00our’ ..during the growth period.
The epiphyses are the ends of long bones and formed of a
bony nuoleous of the oanoellous type oovered with the artioular
oartilage· ’and separated from the metaphysis by the epiphyseal
oartilage or the gro1rthplate.
THEARTIOULAORARTILAGE.
It is of the hyaline type with smoothglistening surfaoe
not covered by periqhondrium and of various thiokness.
Histologioally. it is an avascular tissue formed of few
chondrooytes in a gelly like matrix.
The cells are of Tarious sizes. shapes and numberswith
a basophilio granular cytoplasm and a: IrUcleus.
They are surrounded by Lacunae, with a limiting member--
ane around the cell. The oell organells inolude the nucleus
which i. bimembranousand. have coarse ohromatine. ribosomes.
endoplasmic reticulum( rough and smooth). Gols! apparatus •
mitochondria. microtubules and oentn:lJoles Oell inlllusions
as glyoogen and lipid granules are seen.
The matrix is formed of collagenous fibres of periodici
ty about 64nm and they are arranged in bundles0
!beording to the ground substance and the fibrous elements.
the matriX is divided into pericellular. teritorlal
and interterritioral aatrices.
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Chemically the matrix, is formed of proteolgy-cans,
collagen, water and small amounts of glycoproteins, lipids
and inorganic compounds.
The growth plate is responsible for growth in length
and is formed of four zones: the zone of resting chondroblast,
the a.one of young IlI:oliferating chondrocytes-, the
zone of maturing cartilage and the zone of calcification.
Types of osteoohondritisjthey may be:
I- Articular, that may be primary affecting the cartilage
or secondary to affection of the subjacent bones.
2- Nonarticular ~ither at tendon or ligament attachments
or at impact sites.
3- Physeal types of long bones or vertebrae.
Pathology: They affect the endochondral ossification.
• Affect boys more than girls with ratio of 4:I and
occur during the age peri ode of bone growth mostly between
6 - IO years.
• Tarious sites are liable to affection.
• !hey affect more than one in one patient.
• M8J’,JY theories were put to describe the etiology which
may be of traumatic, vascular infective: .-or hormonal nature
but no single cause can explain the pathology, but the first
two being the mos~ valuable.
Pathological changes:
All of them are charcterised by bone necrosis,
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fragmentation and re”generation stages with the result of
deformed epiphyses and degenerative osteorthritis, but
if weLl treated, the epiphysis may regain their original
shape.
In osteochondritis dissecans, loose bodi@s are seen.
Diagnosis depends on a history which is mostly of
epis04esaf liIIJlingand pain with few signs as effusion or
limitation of mevement of any degree, and deformities iu,late
cases •
X-ray pictures ranges from increased density to fragmentation
or col1apae of the epiphyses. Arthritic changes
are seen in late stages.
Most of these lesions nan only conservative measures and
~he aim of treatment is to maintain the integrity of the
epiphysis and the anatomioal relations of the joint •
Surgery may be needed in some cases , these may be removal
of loose bodies or their fixation by bone pegs, re~lacm~-
ent of deformed bone by implant or osteotomies for the residual
defprmities.
The results of too’two lines are uearly similar and do
not alter the prognosis.