OSTEONECROSIS & OSTEOCHONDROSIS

EPIPHYSEAL OSTEONECROSIS:

  One of the early findings of epiphyseal osteonecrosis is ill-defined increased density. Can you identify which lesser metatarsal epiphysis is affected?

DIAMETAPHYSEAL OSTEONECROSIS (AKA BONE INFARCT):

    The classic appearance of a diametaphyseal bone infarct is shown in this patient. Identify the serpiginous calcification in the distal tibia in both the mortise and lateral views.

FREIBERG'S DISEASE, RIGHT SECOND METATARSAL:

  This is the classic appearance of an old, healed lesser metatarsal epiphyseal osteonecrosis after it has remodeled and developed secondary osteoarthritis. This presentation is usually an incidental finding and not symptomatic. Many times the patient does not recall any traumatic event.

NAVICULAR OSTEOCHONDROSIS: KOHLER'S DISEASE:

    Fragmentation, smaller size, and sclerosis of the navicular ossification center may or may not be normal development. (This patient's left foot navicular bone demonstrates asymmetrical fragmentation and smaller size, but lacks sclerosis.) If symptomatic, it is frequently diagnosed as Kohler's disease, which suggests abnormality. It more than likely is just variant development in this particular example.

HAWKIN'S SIGN:

  Note the subchondral linear lucency that parallels the outer margin of the talar dome. This finding is known as Hawkin's sign and indicates that there is an intact vascular supply to the affected bone.

 

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© Copyright 1998, Robert A. Christman, D.P.M.

These articles and figures may not be published, reposted, or redistributed without permission from Dr. Christman.

This page was updated May 5, 1998.