The Experts below are selected from a list of 2940 Experts worldwide ranked by ideXlab platform
Cathy S Carlson - One of the best experts on this subject based on the ideXlab platform.
-
identification of areas of epiphyseal cartilage necrosis at predilection sites of juvenile osteochondritis dissecans in pediatric cadavers
Journal of Bone and Joint Surgery American Volume, 2018Co-Authors: Ferenc Toth, Kevin G Shea, Marc Tompkins, Jutta M Ellermann, Cathy S CarlsonAbstract:BACKGROUND: The pathogenesis of human juvenile osteochondritis dissecans (JOCD) remains poorly understood, with multiple factors implicated, including ischemia, repetitive trauma, and genetic predisposition. Similarities in the predilection site and the diagnostic and clinical features of JOCD to the well-characterized veterinary counterpart, Osteochondrosis dissecans, suggest that, similar to the animal disease, the pathogenesis JOCD may also be initiated in the first few years of life, when disruption of blood supply to the epiphyseal growth cartilage leads to failure of endochondral ossification. To gather data in support of the hypothesis that JOCD and Osteochondrosis dissecans have a shared pathogenesis, biopsy specimens obtained from predilection sites of JOCD in juvenile human cadavers were histologically examined to determine whether they contained lesions similar to those found in animals diagnosed with subclinical Osteochondrosis dissecans. METHODS: In this descriptive laboratory study, 59 biopsy specimens (6 mm in diameter) were harvested from the central aspect (i.e., the notch side) of the femoral condyles of 26 human cadavers (1 month to 11 years old). Specimens were histologically evaluated for the presence of areas of cartilage necrosis and the morphology of cartilage canal blood vessels. RESULTS: Locally extensive areas of necrotic epiphyseal cartilage were identified in 4 specimens obtained from 3 donors (ages 2 to 4 years). Areas of cartilage necrosis accompanied by focal failure of endochondral ossification or surrounded by subchondral bone were identified in biopsy specimens from 4 donors (ages 4 to 9 years). CONCLUSIONS: The identification of epiphyseal cartilage necrosis identical to that described in animals with subclinical Osteochondrosis, found in biopsy specimens obtained from femoral predilection sites of JOCD in pediatric cadavers, suggests a shared pathogenesis of JOCD in humans and Osteochondrosis dissecans in animals. CLINICAL RELEVANCE: These findings imply that the pathogenesis of human JOCD likely starts 5 to 10 years prior to the development of clinical symptoms. Enhanced understanding of the temporal features of JOCD pathogenesis provides an opportunity for earlier diagnosis and treatment, likely resulting in improved outcomes for this condition in the future.
-
juvenile osteochondritis dissecans of the knee is a result of failure of the blood supply to growth cartilage and Osteochondrosis
Osteoarthritis and Cartilage, 2018Co-Authors: Kristin Olstad, Bjornar Ytrehus, Stina Ekman, Kevin G Shea, Peter C Cannamela, John D Polousky, Cathy S CarlsonAbstract:Summary Objective Juvenile osteochondritis dissecans (JOCD) is similar to Osteochondrosis dissecans (OCD) in animals, which is the result of failure of the cartilage canal blood supply, ischemic chondronecrosis and delayed ossification, or Osteochondrosis. The aim of the current study was to determine if Osteochondrosis lesions occur at predilection sites for JOCD in children. Method Computed tomographic (CT) scans of 23 knees (13 right, 10 left) from 13 children (9 male, 4 female; 1 month to 11 years old) were evaluated for lesions consisting of focal, sharply demarcated, uniformly hypodense defects in the ossification front. Histological validation was performed in 11 lesions from eight femurs. Results Thirty-two lesions consisting of focal, uniformly hypodense defects in the ossification front were identified in the CT scans of 14 human femurs (7 left, 7 right; male, 7–11 years old). Defects corresponded to areas of ischemic chondronecrosis in sections from all 11 histologically validated lesions. Intra-cartilaginous secondary responses comprising proliferation of adjacent chondrocytes and vessels were detected in six and two lesions, whereas intra-osseous responses including accumulation of chondroclasts and formation of granulation tissue occurred in 10 and six lesions, respectively. One CT cyst-like lesion contained both a pseudocyst and a true cyst in histological sections. Conclusion Changes identical to Osteochondrosis in animals were detected at predilection sites for JOCD in children, and confirmed to represent failure of the cartilage canal blood supply and ischemic chondronecrosis in histological sections.
-
multiparametric mri of epiphyseal cartilage necrosis Osteochondrosis with histological validation in a goat model
PLOS ONE, 2015Co-Authors: Luning Wang, Cathy S Carlson, Ferenc Toth, Mikko J Nissi, Jonah Shaver, Casey P Johnson, Jinjin Zhang, Michael Garwood, Jutta M EllermannAbstract:Purpose To evaluate multiple MRI parameters in a surgical model of Osteochondrosis (OC) in goats.
-
novel application of magnetic resonance imaging demonstrates characteristic differences in vasculature at predilection sites of osteochondritis dissecans
American Journal of Sports Medicine, 2015Co-Authors: Ferenc Toth, Kevin G Shea, John D Polousky, Jutta M Ellermann, Luning Wang, Mikko J Nissi, Cathy S CarlsonAbstract:Background:Understanding the pathogenesis of Osteochondrosis/osteochondritis dissecans and other developmental orthopaedic diseases that are thought to occur secondary to defects in vascular supply to growth/epiphyseal cartilage has been hampered by the inability to image the vasculature in this tissue. This is particularly true in human beings due to limitations of current imaging techniques and the lack of availability of appropriate cadaveric samples for histological studies.Hypothesis:Susceptibility-weighted imaging, an MRI sequence, allows identification of characteristic differences in the vascular architecture in species that are affected by Osteochondrosis/osteochondritis dissecans on the femoral condyle (humans and pigs) versus a species that is free of the disease (goat).Study Design:Controlled laboratory study.Materials:Distal femora from cadavers of juvenile humans (n = 5), pigs (n = 3), and goats (n = 3) were scanned in a 9.4-T MRI scanner using susceptibility-weighted imaging. Three-dimensio...
-
an update on the pathogenesis of Osteochondrosis
Veterinary Pathology, 2015Co-Authors: Kristin Olstad, Stina Ekman, Cathy S CarlsonAbstract:Osteochondrosis is defined as a focal disturbance in endochondral ossification. The cartilage superficial to an Osteochondrosis lesion can fracture, giving rise to fragments in joints known as Osteochondrosis dissecans (OCD). In pigs and horses, it has been confirmed that the disturbance in ossification is the result of failure of the blood supply to epiphyseal growth cartilage and associated ischemic chondronecrosis. The earliest lesion following vascular failure is an area of ischemic chondronecrosis at an intermediate depth of the growth cartilage (Osteochondrosis latens) that is detectable ex vivo, indirectly using contrast-enhanced micro- and conventional computed tomography (CT) or directly using adiabatic T1ρ magnetic resonance imaging. More chronic lesions of ischemic chondronecrosis within the ossification front (Osteochondrosis manifesta) are detectable by the same techniques and have also been followed longitudinally in pigs using plain CT. The results confirm that lesions sometimes undergo spontaneous resolution, and in combination, CT and histology observations indicate that this occurs by filling of radiolucent defects with bone from separate centers of endochondral ossification that form superficial to lesions and by phagocytosis and intramembranous ossification of granulation tissue that forms deep to lesions. Research is currently aimed at discovering the cause of the vascular failure in Osteochondrosis, and studies of spontaneous lesions suggest that failure is associated with the process of incorporating blood vessels into the advancing ossification front during growth. Experimental studies also show that bacteremia can lead to vascular occlusion. Future challenges are to differentiate between causes of vascular failure and to discover the nature of the heritable predisposition for Osteochondrosis.
Sheila Laverty - One of the best experts on this subject based on the ideXlab platform.
-
ultrasonographic screening for subclinical Osteochondrosis of the femoral trochlea in foals 28 166 days old a prospective farm study
Equine Veterinary Journal, 2018Co-Authors: Gabrielle Martel, Julien Olive, D Crowley, J Halley, Sheila LavertyAbstract:BACKGROUND Extensive osteochondritis dissecans (OCD) lesions of the lateral ridge of the trochlea of the femur (LRTF), the most common OCD-affected site in the stifle, have a poor outcome with surgical debridement and can be career ending. The early detection of Osteochondrosis lesions and their conservative management holds the promise to enhance outcome. We hypothesise that ultrasonography is a valuable field screening tool to detect and monitor early subclinical LRTF Osteochondrosis. OBJECTIVES The goals were to 1) describe the normal ultrasonographic features of the LRTF in foals of different ages and 2) screen a foal cohort at the farm for early subclinical Osteochondrosis lesions. STUDY DESIGN Prospective cohort study. METHODS The LRTF of both hindlimbs of Thoroughbred foals (n = 46, 27-166 days old) were imaged once with ultrasonography and radiography (lateromedial and caudolateral-craniomedial oblique views). Cartilage thickness, ossification front indentation of the chondro-osseous junction and epiphyseal vascularisation were assessed on ultrasonography. Follow-up radiographs were taken as yearlings. RESULTS The cartilage thickness, ossification front indentation and epiphyseal vascularisation significantly decreased with advancing maturity. Subclinical Osteochondrosis lesions, characterised by semicircular indentations in the ossification front (indirect evidence of focal failure of ossification and retained cartilage) were detected in six foals (28-145 days old), both with radiography and ultrasonography. Ultrasonography provided a better overall subjective assessment of the Osteochondrosis lesion topography (length, depth and the width) compared with radiography. MAIN LIMITATIONS Post-mortem validation of lesions was not possible. CONCLUSION Ultrasonography of the LRTF is a practical, inexpensive and reliable technique to discriminate physiological from pathological events at the LRTF in young foals. It revealed the complex topography of the chondro-osseous junction permitting a rapid, comprehensive assessment of the subclinical Osteochondrosis lesions in very young foals.
-
validation of the ultrasonographic assessment of the femoral trochlea epiphyseal cartilage in foals at Osteochondrosis predilected sites with magnetic resonance imaging and histology
Equine Veterinary Journal, 2017Co-Authors: Gabrielle Martel, C Forget, Guillaume Gilbert, H Richard, T Moser, Julien Olive, Sheila LavertyAbstract:SummaryBackground Non-invasive imaging tools are needed to screen foal femoropatellar joints to detect subclinical Osteochondrosis lesions due to focal failure of endochondral ossification to enhance early management to optimise intrinsic healing events. Recently investigations employing 3T susceptibility-weighted MRI (3T SWI MRI) and CT have demonstrated their capacity for early Osteochondrosis diagnosis, but these technologies are not practical for field screening. We postulate that ultrasonography is a valuable field tool for the detection of subclinical Osteochondrosis lesions. Objectives The goals were 1) to describe the sonographic features of the femoral trochlea of healthy and Osteochondrosis-predisposed neonatal foals, 2) to validate the capacity of ultrasound to assess cartilage canal vascular archictecture and the ossification front and 3) to evaluate field feasibility in a pilot study. Study design Experimental study. Methods Ultrasonographic evaluation of Osteochondrosis predisposed (n = 10) and control (n = 6) femoral trochleas was performed ex vivo and compared with site-matched histological sections and 3T SWI MRI. The articular and epiphyseal cartilage thickness, the ossification front indentation and the cartilage canal vascular archictecture were assessed at each ROI. Femoral trochleae of foals (n = 3) aged 1, 3 and 6 months were also evaluated with ultrasonography in field. Results Ultrasonographic measurements strongly correlated with the histological measurements. There was no difference in the cartilage thickness or ossification front indentation between control and Osteochondrosis-predisposed specimens. The cartilage canal vascular archictecture on ultrasonograms corresponded with the vessel pattern observed on site-matched histology and 3T SWI MRI. Main limitations The number of specimens for study was limited, and no early Osteochondrosis lesions were present within the predilected group, but a field study is now underway. Conclusion Ultrasonographic examination of the femoral trochlea permitted accurate evaluation of cartilage thickness, cartilage canal vascular archictecture and ossification front indentation in young foals and is a promising, practical tool for screening subclinical Osteochondrosis and monitoring and managing lesions at important clinical sites. This article is protected by copyright. All rights reserved.
-
femoral epiphyseal cartilage matrix changes at predilection sites of equine Osteochondrosis quantitative mri second harmonic microscopy and histological findings
Journal of Orthopaedic Research, 2016Co-Authors: Gabrielle Martel, Guillaume Gilbert, H Richard, T Moser, Charlesandre Couture, Stephane Bancelin, Sabrina Kiss, Francois Legare, Sheila LavertyAbstract:Osteochondrosis is an ischemic chondronecrosis of epiphyseal growth cartilage that results in focal failure of endochondral ossification and osteochondritis dissecans at specific sites in the epiphyses of humans and animals, including horses. The upstream events leading to the focal ischemia remain unknown. The epiphyseal growth cartilage matrix is composed of proteoglycan and collagen macromolecules and encases its vascular tree in canals. The matrix undergoes major dynamic changes in early life that could weaken it biomechanically and predispose it to focal trauma and vascular failure. Subregions in neonatal foal femoral epiphyses (n = 10 Osteochondrosis predisposed; n = 6 control) were assessed for proteoglycan and collagen structure/content employing 3T quantitative MRI (3T qMRI: T1ρ and T2 maps). Site-matched validations were made with histology, immunohistochemistry, and second-harmonic microscopy. Growth cartilage T1ρ and T2 relaxation times were significantly increased (p < 0.002) within the proximal third of the trochlea, a site predisposed to Osteochondrosis, when compared with other regions. However, this was observed in both control and Osteochondrosis predisposed specimens. Microscopic evaluation of this region revealed an expansive area with low proteoglycan content and a hypertrophic-like appearance on second-harmonic microscopy. We speculate that this matrix structure and composition, though physiological, may weaken the epiphyseal growth cartilage biomechanically in focal regions and could enhance the risk of vascular failure with trauma leading to Osteochondrosis. However, additional investigations are now required to confirm this. 3T qMRI will be useful for future non-invasive longitudinal studies to track the Osteochondrosis disease trajectory in animals and humans. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1743-1752, 2016.
-
pathogenesis of epiphyseal Osteochondrosis
Veterinary Journal, 2013Co-Authors: Sheila Laverty, Christiane GirardAbstract:Osteochondrosis (OC) of the articular epiphyseal cartilage complex (AECC) is a developmental disease that is present in the first weeks of life. It is characterized by focal chondronecrosis and retention of growth cartilage due to failure of endochondral ossification. Fissures may extend from the lesion through the overlying articular cartilage to create a cartilage flap and an osteochondral fragment. This articular form is known as osteochondritis dissecans (OCD). There have been many hypotheses about the etiopathogenesis of OC of the AECC including, amongst others, ischemia of growth cartilage or altered cartilage type II collagen metabolism. The ischemia theory proposes that necrosis of the vessels in the cartilage canals of the sub-articular growth cartilage leads to necrosis of chondrocytes and retention of necrotic cartilage. Several studies have measured biomarkers in serum and synovial fluid to demonstrate a consistent increase in type II collagen synthesis in young animals of different species. Although these changes could represent lesion reparative events, there is no comparable increase in the synthesis of cartilage matrix proteoglycan molecule. It is therefore speculated that an altered type II collagen metabolism may be involved in the early changes associated with OC. Further studies of OC susceptible animals in utero and the first weeks of life are required to elucidate the cause of vessel necrosis and the exact role of type II collagen structure and metabolism in OC.
-
alterations in cartilage type ii procollagen and aggrecan contents in synovial fluid in equine Osteochondrosis
Journal of Orthopaedic Research, 2000Co-Authors: Sheila Laverty, M Ionescu, Marcel Marcoux, Ludovic Boure, B Doize, A R PooleAbstract:The etiology and pathophysiology of Osteochondrosis remain poorly understood because it is difficult to obtain material from lesions in the early stage of this disease and because there is no satisfactory experimental animal model. We wished to determine whether there are changes in articular cartilage turnover in equine Osteochondrosis, which closely resembles the human disease, by assaying cartilage matrix molecules in synovial fluids. We used immunoassays that measure a keratan sulfate epitope and the epitope 846 on the cartilage proteoglycan aggrecan and the C-propeptide of cartilage type-II procollagen, which is released following the synthesis of this molecule, to analyse synovial fluids from equine tarsocrural joints with and without Osteochondrosis. In young horses with Osteochondrosis, there was a significant increase of C-propeptide of type-II procollagen accompanied by a decrease in the 846 and keratan sulfate epitopes. The results identify differential alterations in aggrecan and type-II collagen turnover in the cartilage matrix in young animals with Osteochondrosis that may contribute to the pathological degeneration of articular cartilage in this disease.
Natsuo Yasui - One of the best experts on this subject based on the ideXlab platform.
-
conservative treatment for Osteochondrosis of the humeral capitellum
American Journal of Sports Medicine, 2008Co-Authors: Tetsuya Matsuura, Takenobu Iwase, Yoshitsugu Takeda, Shinji Kashiwaguchi, Natsuo YasuiAbstract:BACKGROUND: Conservative treatment is recommended for the early stage of Osteochondrosis of the humeral capitellum. However, the outcome of conservative treatment has not been well documented. HYPOTHESIS: Osteochondrosis of the humeral capitellum detected at an early stage responds well to conservative treatment. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively reviewed 176 patients with Osteochondrosis of the humeral capitellum. There were 134 lesions that were stage I (radiolucent area) in patients with a mean age of 11.5 years and 42 lesions that were stage II (nondisplaced fragments) in patients with a mean age of 13.9 years based on anteroposterior radiographs of the elbow in 45 degrees of flexion. Conservative treatment was performed on 101 patients. The remaining 75 patients did not follow the authors' advice. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Follow-up radiographs were taken at 1-month intervals. At a mean follow-up of 24 months, all patients were evaluated clinically and radiographically. RESULTS: Conservative management produced healing in 90.5% of stage I lesions and 52.9% of stage II lesions. The mean period required for healing was 14.9 months in stage I and 12.3 months in stage II. Sixty-six of 84 (78.6%) stage I patients and 9 of 17 (52.9%) stage II patients returned to competitive-level baseball. Of the 75 patients who did not follow our advice, healing was observed in 17 (22.7%). The healing rate was higher for the 101 patients who followed our advice as opposed to the 75 patients who did not. CONCLUSION: Osteochondrosis of the humeral capitellum can be successfully treated conservatively if treatment is begun in an early stage of the disease.
-
conservative treatment for Osteochondrosis of the humeral capitellum
American Journal of Sports Medicine, 2008Co-Authors: Tetsuya Matsuura, Takenobu Iwase, Yoshitsugu Takeda, Shinji Kashiwaguchi, Natsuo YasuiAbstract:BACKGROUND: Conservative treatment is recommended for the early stage of Osteochondrosis of the humeral capitellum. However, the outcome of conservative treatment has not been well documented. HYPOTHESIS: Osteochondrosis of the humeral capitellum detected at an early stage responds well to conservative treatment. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively reviewed 176 patients with Osteochondrosis of the humeral capitellum. There were 134 lesions that were stage I (radiolucent area) in patients with a mean age of 11.5 years and 42 lesions that were stage II (nondisplaced fragments) in patients with a mean age of 13.9 years based on anteroposterior radiographs of the elbow in 45 degrees of flexion. Conservative treatment was performed on 101 patients. The remaining 75 patients did not follow the authors' advice. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Follow-up radiographs were taken at 1-month intervals. At a mean follow-up of 24 months, all patients were evaluated clinically and radiographically. RESULTS: Conservative management produced healing in 90.5% of stage I lesions and 52.9% of stage II lesions. The mean period required for healing was 14.9 months in stage I and 12.3 months in stage II. Sixty-six of 84 (78.6%) stage I patients and 9 of 17 (52.9%) stage II patients returned to competitive-level baseball. Of the 75 patients who did not follow our advice, healing was observed in 17 (22.7%). The healing rate was higher for the 101 patients who followed our advice as opposed to the 75 patients who did not. CONCLUSION: Osteochondrosis of the humeral capitellum can be successfully treated conservatively if treatment is begun in an early stage of the disease.
-
conservative treatment for Osteochondrosis of the humeral capitellum
American Journal of Sports Medicine, 2008Co-Authors: Tetsuya Matsuura, Takenobu Iwase, Yoshitsugu Takeda, Shinji Kashiwaguchi, Natsuo YasuiAbstract:BackgroundConservative treatment is recommended for the early stage of Osteochondrosis of the humeral capitellum. However, the outcome of conservative treatment has not been well documented.HypothesisOsteochondrosis of the humeral capitellum detected at an early stage responds well to conservative treatment.Study DesignCohort study; Level of evidence, 3.MethodsWe retrospectively reviewed 176 patients with Osteochondrosis of the humeral capitellum. There were 134 lesions that were stage I (radiolucent area) in patients with a mean age of 11.5 years and 42 lesions that were stage II (nondisplaced fragments) in patients with a mean age of 13.9 years based on anteroposterior radiographs of the elbow in 45° of flexion. Conservative treatment was performed on 101 patients. The remaining 75 patients did not follow the authors’ advice. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Follow-up radiographs were taken at 1 -month intervals. At a mean follow-up of ...
Kevin G Shea - One of the best experts on this subject based on the ideXlab platform.
-
identification of areas of epiphyseal cartilage necrosis at predilection sites of juvenile osteochondritis dissecans in pediatric cadavers
Journal of Bone and Joint Surgery American Volume, 2018Co-Authors: Ferenc Toth, Kevin G Shea, Marc Tompkins, Jutta M Ellermann, Cathy S CarlsonAbstract:BACKGROUND: The pathogenesis of human juvenile osteochondritis dissecans (JOCD) remains poorly understood, with multiple factors implicated, including ischemia, repetitive trauma, and genetic predisposition. Similarities in the predilection site and the diagnostic and clinical features of JOCD to the well-characterized veterinary counterpart, Osteochondrosis dissecans, suggest that, similar to the animal disease, the pathogenesis JOCD may also be initiated in the first few years of life, when disruption of blood supply to the epiphyseal growth cartilage leads to failure of endochondral ossification. To gather data in support of the hypothesis that JOCD and Osteochondrosis dissecans have a shared pathogenesis, biopsy specimens obtained from predilection sites of JOCD in juvenile human cadavers were histologically examined to determine whether they contained lesions similar to those found in animals diagnosed with subclinical Osteochondrosis dissecans. METHODS: In this descriptive laboratory study, 59 biopsy specimens (6 mm in diameter) were harvested from the central aspect (i.e., the notch side) of the femoral condyles of 26 human cadavers (1 month to 11 years old). Specimens were histologically evaluated for the presence of areas of cartilage necrosis and the morphology of cartilage canal blood vessels. RESULTS: Locally extensive areas of necrotic epiphyseal cartilage were identified in 4 specimens obtained from 3 donors (ages 2 to 4 years). Areas of cartilage necrosis accompanied by focal failure of endochondral ossification or surrounded by subchondral bone were identified in biopsy specimens from 4 donors (ages 4 to 9 years). CONCLUSIONS: The identification of epiphyseal cartilage necrosis identical to that described in animals with subclinical Osteochondrosis, found in biopsy specimens obtained from femoral predilection sites of JOCD in pediatric cadavers, suggests a shared pathogenesis of JOCD in humans and Osteochondrosis dissecans in animals. CLINICAL RELEVANCE: These findings imply that the pathogenesis of human JOCD likely starts 5 to 10 years prior to the development of clinical symptoms. Enhanced understanding of the temporal features of JOCD pathogenesis provides an opportunity for earlier diagnosis and treatment, likely resulting in improved outcomes for this condition in the future.
-
juvenile osteochondritis dissecans of the knee is a result of failure of the blood supply to growth cartilage and Osteochondrosis
Osteoarthritis and Cartilage, 2018Co-Authors: Kristin Olstad, Bjornar Ytrehus, Stina Ekman, Kevin G Shea, Peter C Cannamela, John D Polousky, Cathy S CarlsonAbstract:Summary Objective Juvenile osteochondritis dissecans (JOCD) is similar to Osteochondrosis dissecans (OCD) in animals, which is the result of failure of the cartilage canal blood supply, ischemic chondronecrosis and delayed ossification, or Osteochondrosis. The aim of the current study was to determine if Osteochondrosis lesions occur at predilection sites for JOCD in children. Method Computed tomographic (CT) scans of 23 knees (13 right, 10 left) from 13 children (9 male, 4 female; 1 month to 11 years old) were evaluated for lesions consisting of focal, sharply demarcated, uniformly hypodense defects in the ossification front. Histological validation was performed in 11 lesions from eight femurs. Results Thirty-two lesions consisting of focal, uniformly hypodense defects in the ossification front were identified in the CT scans of 14 human femurs (7 left, 7 right; male, 7–11 years old). Defects corresponded to areas of ischemic chondronecrosis in sections from all 11 histologically validated lesions. Intra-cartilaginous secondary responses comprising proliferation of adjacent chondrocytes and vessels were detected in six and two lesions, whereas intra-osseous responses including accumulation of chondroclasts and formation of granulation tissue occurred in 10 and six lesions, respectively. One CT cyst-like lesion contained both a pseudocyst and a true cyst in histological sections. Conclusion Changes identical to Osteochondrosis in animals were detected at predilection sites for JOCD in children, and confirmed to represent failure of the cartilage canal blood supply and ischemic chondronecrosis in histological sections.
-
novel application of magnetic resonance imaging demonstrates characteristic differences in vasculature at predilection sites of osteochondritis dissecans
American Journal of Sports Medicine, 2015Co-Authors: Ferenc Toth, Kevin G Shea, John D Polousky, Jutta M Ellermann, Luning Wang, Mikko J Nissi, Cathy S CarlsonAbstract:Background:Understanding the pathogenesis of Osteochondrosis/osteochondritis dissecans and other developmental orthopaedic diseases that are thought to occur secondary to defects in vascular supply to growth/epiphyseal cartilage has been hampered by the inability to image the vasculature in this tissue. This is particularly true in human beings due to limitations of current imaging techniques and the lack of availability of appropriate cadaveric samples for histological studies.Hypothesis:Susceptibility-weighted imaging, an MRI sequence, allows identification of characteristic differences in the vascular architecture in species that are affected by Osteochondrosis/osteochondritis dissecans on the femoral condyle (humans and pigs) versus a species that is free of the disease (goat).Study Design:Controlled laboratory study.Materials:Distal femora from cadavers of juvenile humans (n = 5), pigs (n = 3), and goats (n = 3) were scanned in a 9.4-T MRI scanner using susceptibility-weighted imaging. Three-dimensio...
Tetsuya Matsuura - One of the best experts on this subject based on the ideXlab platform.
-
conservative treatment for Osteochondrosis of the humeral capitellum
American Journal of Sports Medicine, 2008Co-Authors: Tetsuya Matsuura, Takenobu Iwase, Yoshitsugu Takeda, Shinji Kashiwaguchi, Natsuo YasuiAbstract:BACKGROUND: Conservative treatment is recommended for the early stage of Osteochondrosis of the humeral capitellum. However, the outcome of conservative treatment has not been well documented. HYPOTHESIS: Osteochondrosis of the humeral capitellum detected at an early stage responds well to conservative treatment. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively reviewed 176 patients with Osteochondrosis of the humeral capitellum. There were 134 lesions that were stage I (radiolucent area) in patients with a mean age of 11.5 years and 42 lesions that were stage II (nondisplaced fragments) in patients with a mean age of 13.9 years based on anteroposterior radiographs of the elbow in 45 degrees of flexion. Conservative treatment was performed on 101 patients. The remaining 75 patients did not follow the authors' advice. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Follow-up radiographs were taken at 1-month intervals. At a mean follow-up of 24 months, all patients were evaluated clinically and radiographically. RESULTS: Conservative management produced healing in 90.5% of stage I lesions and 52.9% of stage II lesions. The mean period required for healing was 14.9 months in stage I and 12.3 months in stage II. Sixty-six of 84 (78.6%) stage I patients and 9 of 17 (52.9%) stage II patients returned to competitive-level baseball. Of the 75 patients who did not follow our advice, healing was observed in 17 (22.7%). The healing rate was higher for the 101 patients who followed our advice as opposed to the 75 patients who did not. CONCLUSION: Osteochondrosis of the humeral capitellum can be successfully treated conservatively if treatment is begun in an early stage of the disease.
-
conservative treatment for Osteochondrosis of the humeral capitellum
American Journal of Sports Medicine, 2008Co-Authors: Tetsuya Matsuura, Takenobu Iwase, Yoshitsugu Takeda, Shinji Kashiwaguchi, Natsuo YasuiAbstract:BACKGROUND: Conservative treatment is recommended for the early stage of Osteochondrosis of the humeral capitellum. However, the outcome of conservative treatment has not been well documented. HYPOTHESIS: Osteochondrosis of the humeral capitellum detected at an early stage responds well to conservative treatment. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively reviewed 176 patients with Osteochondrosis of the humeral capitellum. There were 134 lesions that were stage I (radiolucent area) in patients with a mean age of 11.5 years and 42 lesions that were stage II (nondisplaced fragments) in patients with a mean age of 13.9 years based on anteroposterior radiographs of the elbow in 45 degrees of flexion. Conservative treatment was performed on 101 patients. The remaining 75 patients did not follow the authors' advice. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Follow-up radiographs were taken at 1-month intervals. At a mean follow-up of 24 months, all patients were evaluated clinically and radiographically. RESULTS: Conservative management produced healing in 90.5% of stage I lesions and 52.9% of stage II lesions. The mean period required for healing was 14.9 months in stage I and 12.3 months in stage II. Sixty-six of 84 (78.6%) stage I patients and 9 of 17 (52.9%) stage II patients returned to competitive-level baseball. Of the 75 patients who did not follow our advice, healing was observed in 17 (22.7%). The healing rate was higher for the 101 patients who followed our advice as opposed to the 75 patients who did not. CONCLUSION: Osteochondrosis of the humeral capitellum can be successfully treated conservatively if treatment is begun in an early stage of the disease.
-
conservative treatment for Osteochondrosis of the humeral capitellum
American Journal of Sports Medicine, 2008Co-Authors: Tetsuya Matsuura, Takenobu Iwase, Yoshitsugu Takeda, Shinji Kashiwaguchi, Natsuo YasuiAbstract:BackgroundConservative treatment is recommended for the early stage of Osteochondrosis of the humeral capitellum. However, the outcome of conservative treatment has not been well documented.HypothesisOsteochondrosis of the humeral capitellum detected at an early stage responds well to conservative treatment.Study DesignCohort study; Level of evidence, 3.MethodsWe retrospectively reviewed 176 patients with Osteochondrosis of the humeral capitellum. There were 134 lesions that were stage I (radiolucent area) in patients with a mean age of 11.5 years and 42 lesions that were stage II (nondisplaced fragments) in patients with a mean age of 13.9 years based on anteroposterior radiographs of the elbow in 45° of flexion. Conservative treatment was performed on 101 patients. The remaining 75 patients did not follow the authors’ advice. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Follow-up radiographs were taken at 1 -month intervals. At a mean follow-up of ...
