Department of Companion Animal Clinical Sciences, Equine Section, Norwegian University of Life Sciences, Oslo, Norway.
Department of Orthopedics, St. Luke's Sports Medicine, Boise, ID, USA.
Osteoarthritis Cartilage. 2018 Dec;26(12):1691-1698. doi: 10.1016/j.joca.2018.06.019. Epub 2018 Sep 21.
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.
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.
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.
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.
青少年剥脱性骨软骨炎（JOCD）类似于动物的骨软骨病（OCD），是软骨管血供衰竭、缺血性软骨坏死和骨化延迟或骨软骨病的结果。本研究旨在确定儿童 JOCD 的好发部位是否存在骨软骨病病变。
对 13 名儿童（9 名男性，4 名女性；1 个月至 11 岁）的 23 个膝关节（13 个右侧，10 个左侧）进行计算机断层扫描（CT）检查，以评估存在于骨化前缘的局灶性、边界清晰、均匀低信号缺损的病变。对 8 个股骨中的 11 个病变进行了组织学验证。
在 14 个人类股骨的 CT 扫描中发现了 32 个病变，这些病变包括骨化前缘的局灶性、均匀低信号缺损（7 个左侧，7 个右侧；男性，7-11 岁）。在所有 11 个经组织学验证的病变切片中，缺损对应于缺血性软骨坏死区。在 6 个和 2 个病变中检测到包含相邻软骨细胞和血管增生的软骨内继发性反应，而在 10 个和 6 个病变中分别检测到包含破骨细胞积聚和肉芽组织形成的骨内反应。一个 CT 样囊肿样病变在组织学切片中同时包含假性囊肿和真性囊肿。
在儿童 JOCD 的好发部位检测到与动物骨软骨病相同的变化，并在组织学切片中证实为软骨管血供衰竭和缺血性软骨坏死。
