EC Paediatrics

Osteochondritis is a condition of the subchondral bone and cartilage of children between three and ten years old in the majority of cases, due to aseptic cephalic necrosis of an etiology not yet elucidated. It results in intermittent pain and limitation of joint movement. Radiography is essential for the diagnosis and makes it possible to define the evolutionary phase (necrosis, revascularization, reconstruction, sequelae), as well as the severity of the cephalic attack by the Herring classification. Scintigraphy allows preradiological diagnosis, but magnetic resonance imaging represents the gold standard offering a much more precise analysis of lesions.

The age of onset, the severity of the stiffness, the progressive stage, the classification and the occurrence of progressive eccentricity are the bases of the therapeutic choice. Treatment can be orthopedic in the form of prolonged discharge, bed traction or abduction splint, which are less and less used today. In certain specific indications, surgery often modifies the natural history of the disease. In severe forms, progression can lead to relatively early osteoarthritis.

Keywords: Osteochondritis; Necrosis; Revascularization; Reconstruction; Sequelae

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