Tibial tubercle avulsion fractures (TTAFs) are rare but typical in children and adolescents and Osgood-Schlatter disease (OSD) may be involved in their pathogenesis. However, few publications have reported the relationship between OSD and TTAF. A 16-year-old healthy male adolescent presented with pain, swelling and limited range of motion of the right knee following sudden acceleration while running. Based on the radiographic evidence, the patient was diagnosed with an avulsion fracture of the right tibial tubercle and OSD. Open reduction and internal fixation were performed using two cannulated screws and two Kirschner wires. The patient returned to preinjury activity levels at the 12-month follow-up postoperatively. This case report aimed to highlight this unique injury pattern. For patients with TTAFs, not only should the fracture be treated, but the cause of the fracture, such as OSD, should also be given appropriate treatment.

BACKGROUND: The etiology of osteochondrosis dissecans (OCD), a chondropathy associated with detachment of the subchondral bone and the overlaying cartilage, is not yet fully understood. While repetitive physical exercise-related stress is usually assumed to be the main risk factor for the occurrence of OCD, genetic predisposition could have an underestimated influence on the development of the disease.
METHODS: We report a case of monozygotic twins with almost identical stages of bilateral osteochondrosis dissecans of the knee joint. In both patients, initially, a unilateral lesion occurred; despite restricted physical exercise, in the further course of the disease a lesion also developed on the contralateral side. While the lesion found most recently demonstrated an ongoing healing process at a 6-month follow-up, the other three lesions showed a natural course of healing under conservative treatment with significant clinical as well as radiological improvements after one year and complete consolidation in magnetic resonance imaging (MRI) after 2 years.
CONCLUSIONS: There could be a genetic component to the development of OCD, although this has not yet been proven. Based on a two-year MRI follow-up, we were able to show the self-limiting characteristics of juvenile osteochondrosis dissecans.

BACKGROUND: Our understanding of the efficacy of guided growth surgery with tension-band plating (TBP) in early-onset Blount disease is evolving. Preliminary work has demonstrated that TBP can normalize the mechanical axis, yet its effect on Langenskiöld stage (LS) has not previously been reported. The primary outcome of this study was improvement in LS after TBP. Secondary outcomes were improvement in LS at most recent follow-up and improvement in mechanical axis deviation (MAD), mechanical medial proximal tibial angle, and mechanical lateral distal femoral angle at treatment completion and most recent follow-up.
METHODS: A retrospective review was done of patients with early-onset Blount disease treated with TBP between January 1, 2010, and December 31, 2019, across two institutions. Inclusion criteria were a radiographic diagnosis of early-onset Blount disease (LS changes present), surgery with TBP, and follow-up beyond implant removal. Radiographs before surgery, at removal of hardware (ROH), and at most recent follow-up were evaluated.
RESULTS: Twenty-five limbs in 16 children who underwent TBP at a mean age of 5.8 ± 2.3 years were included. Implants were in situ a mean of 1.9 ± 0.7 years. The mean follow-up after ROH was 3.6 ± 1.4 years. LS ranged from 1 to 5 preoperatively with 14 of 25 limbs (56%) staged ≥3. LS improved in 15 of 25 limbs (60%) at ROH and in 21 of 25 limbs (84%) at most recent follow-up. Langenskiöld changes resolved in 7 of 25 limbs (28%) at most recent follow-up. Preoperatively, the MAD was varus in all limbs, but at ROH, the MAD had improved in 22 of 23 limbs with neutral or valgus alignment in 20 of 23 limbs (87%). At most recent follow-up, 16 of 23 limbs (70%) maintained improved alignment.
CONCLUSIONS: There was improvement/resolution of LS and varus deformity in early-onset Blount disease in most patients who underwent TBP. Based on these results, TBP for early-onset Blount disease should be the first-line surgical treatment.
METHODS: IV.

The purpose of this report is to demonstrate that radiographic evaluation of the canine shoulder joint alone is not sensitive enough to detect migrated osteochondral fragments within the biceps tendon sheath, as a sequela to osteochondrosis dissecans of the caudal humeral head. A 6-months-old, male, 35 kg Hovawart was referred due to chronic intermittent lameness on the left forelimb. Survey radiographs revealed a semilunar radiolucency surrounded by a moderately sclerotic rim at the caudal aspect of the left humeral head, referred to as osteochondrosis dissecans. However, only computed tomography combined with ultrasonography could clearly confirm a dislodged osteochondral fragment within the left biceps tendon sheath and a consequent tenosynovitis. Arthroscopic treatment on the clinically affected left forelimb followed by an additional approach over the left biceps tendon sheath to remove the migrated fragment resulted in a complete remission of the lameness until the last follow-up one year after surgery. In our opinion, computed tomography should be applied in the medical work up of canine shoulder osteochondrosis (OC) as standard. Combined with ultrasonography, it can further aid in complete evaluation of the shoulder joint and reliable exclusion of displaced osteochondral fragments, which might also be missed during arthroscopy when located too far distally.
Ziel dieses Fallberichts ist es, zu zeigen, dass die Röntgenuntersuchung des Schultergelenks allein nicht sensitiv genug ist, um dislozierte Fragmente in die Bizepssehnenscheide als Folge einer Osteochondrosis dissecans (OCD) Läsion am kaudalen Humeruskopf bei Hunden zu diagnostizieren. Ein 6 Monate alter, 35 kg schwerer, männlicher Hovawart wurde aufgrund einer chronisch intermittierenden Lahmheit an der linken Vordergliedmaße überwiesen. Auf den Röntgenaufnahmen zeigte sich eine semilunare Radioluzenz mit sklerotischem Randsaum am linken kaudalen Humeruskopf, typisch für eine osteochondrale Läsion. Jedoch konnte nur durch die Kombination von Computertomografie und Sonografie ein disloziertes osteochondrales Fragment in der linken Bizepssehnenscheide und die daraus resultierende Tenosynovitis eindeutig bestätigt werden. Eine chirurgische Versorgung mittels Arthroskopie, gefolgt von einem Zugang über der linken Bizepssehnenscheide zur Entfernung des migrierten Fragments, führte zu einer vollständigen Remission der Lahmheit bis zur letzten Nachuntersuchung ein Jahr postoperativ. Unserer Meinung nach sollte die Computertomografie als Standard in der Abklärung einer OCD des Schultergelenks bei Hunden eingesetzt werden. In Kombination mit einer Sonografie kann sie zur vollständigen Beurteilung des Schultergelenks und zum zuverlässigen Ausschluss dislozierter osteochondraler Fragmente beitragen, welche auch in der Arthroskopie übersehen werden können.

BACKGROUND: Osteochondrosis dissecans (OCD) is common in the femoropatellar joint in Thoroughbred yearlings for sale at auction and there is no consensus on the effect on racing outcomes.
OBJECTIVE: Describe femoropatellar OCD in juvenile Thoroughbreds and compare the racing performance of affected Thoroughbred horses to siblings and unaffected horses from the same sale.
METHODS: Retrospective case-control study of juvenile horses born 2010-2016.
METHODS: Radiographic reports from 27 Thoroughbred auctions of weanling (5-11 months of age) and yearling (12-22 months of age) horses were reviewed to identify femoropatellar OCD. Age and sex of cases and controls were obtained from the sales catalogue. Racing performance was obtained from an online database. Correlation between lesion characteristics and racing performance were assessed using Pearson and Spearman correlations for continuous and ordinal/categorical variables respectively. Racing performance was compared between cases and sibling controls and age- and sex-matched sale number controls from the same sale with Poisson distribution and log link. Significance level of alpha = 0.05 was used.
RESULTS: Femoropatellar OCD was identified in 429 horses with North American race records. OCD was present on 519 lateral trochlear ridges and 54 medial trochlear ridges. There were more males in the case group (70%) than in the sibling control group (47%). Case racing performance was compared to 1042 sibling and 757 hip controls. There were significant but small decreases in racing metrics of cases and increases in males for years raced, total starts, starts for 2-5 years of age, total placings, and placings at 2-4 years of age. Analysis of specific lesion metrics revealed weak correlations for performance outcomes (positive and negative) resulting in an inability to draw firm conclusions.
CONCLUSIONS: Retrospective study where case management was unknown.
CONCLUSIONS: Femoropatellar OCD in juvenile Thoroughbreds for sale at auction decreases some racing outcomes.
背景: 在纯血马周岁拍卖会的中，股髌关节骨软骨分离症(OCD)很常见，其对比赛结果的影响尚无共识。 目的: 描述幼年纯血马的股髌关节骨软骨分离症，并将有病症的纯血马与其兄弟姐妹马匹和同一场拍卖会无病症的马匹的比赛表现进行比较。 研究设计: 对2010-2016年出生的幼马进行回顾性病例对照研究。 方法: 回顾27场纯血马拍卖会的马匹X线影像报告，分别是断奶驹(5-11个月)和周岁驹(12-22个月)，确定股髌关节骨软骨分离症。病例组和对照组马匹的年龄和性别从拍卖销售目录中获得。出赛成绩从在线数据库中取得。病变特征与赛马表现之间的相关性分别采用Pearson和Spearman法，对连续变量和顺序/分类变量进行评估。用泊松分布和对数连接比较病例组和其兄弟姐妹对照组以及来自同一批次拍卖的年龄和性别匹配臀部对照组的赛马表现。显著性水平α = 0.05。 结果: 在北美比赛记录中，429匹的马发现了股髌关节骨软骨分离症(OCD)。OCD存在于519个外侧滑车(LTR)和54个内侧滑车(MTR)。病例组的公马(70%)比兄弟姐妹对照组(47%)多。病例组赛马表现与1042匹兄弟姐妹组和757匹臀部对照组进行了比较。病例组的比赛指标有微小但显著的下降，而公马在比赛年限，总出赛次数，2-5岁出赛次数，总排名次数和2-4岁排名次数方面的下降更明显。对特定病变指标的分析显示，表现结果(阳性和阴性)呈弱相关性导致无法得出确切的结论。 主要局限性: 回顾性研究，病例后续管理未知。 结论: 拍卖会中出售的幼年纯血马的股髌关节骨软骨分离症会降低比赛成绩预期.

UNASSIGNED: Osteochondroses are a set of conditions concerning the ossification of the developing bone. Higher intensity in sports activities can increase its occurrence in children. There is no consensus on its etiology, with multiple factors being involved. Van Neck-Odelberg disease is a rare osteochondrosis located in ischiopubic synchondrosis. Treatment is mainly conservative, with activity suspension. Addressing and correcting the predisposing factors is crucial to these injuries.
UNASSIGNED: We present a case of a 6-year-old futsal player who experienced mechanical inguinal moderate pain during sports practice. After performing physical examination, laboratory tests, and radiographic evaluation, the patient was diagnosed with Van Neck-Odelberg disease. Sports activities were suspended while a conservative treatment was performed, with subsequent follow-up over 3.5 years. No symptom recurrence was reported.
UNASSIGNED: Increased intensity of sports activities is associated with overuse injuries in children, especially before completing the ossification process. Preventive measures must remain the primary concern in children\'s sports practice.

Sinding-Larsen-Johansson syndrome is an osteochondrosis affecting the inferior pole of the patella. Most cases can be easily diagnosed with adequate clinical history, physical examination, and proper imaging, including conventional radiography, ultrasound, and magnetic resonance imaging. Differentiating this condition from patellar sleeve avulsion fractures is important, since treatment is frequently surgical in the latter. Overlap between these two conditions can also occur. We present a case of an 11-year-old boy, with Sinding-Larsen-Johansson syndrome on both knees and a minimally displaced acute patellar avulsion sleeve fracture of the left knee, which was treated conservatively.

Bowing of the legs is common in childhood. Most times it is considered to be rickets without considering other possibilities. Blount´s disease is a close differential diagnosis which is developmental deformity characterized by intorsion of tibia leading to varus angulation. This case report aims to encourage pediatricians to expand their vision and consider other possibilities when a case of bowing of legs is encountered. Here we report a case of a four-year-old boy with bowing of both legs noticed first at 2.5 years of age. There was no history suggestive of trauma. Development of the child was age appropriate in all domains. He was receiving treatment for rickets for 1.5 years in form of oral vitamin D3 and calcium supplementations. He had no other clinical signs of rickets like frontal bossing, widening of wrists, and rachitic rosary except bowing of legs. His biochemical parameters did not show any alterations that would support the diagnosis of rickets. Weight-bearing radiographs of lower limbs showed medial intorsion of bilateral tibia with metaphyseo-diaphysial angle to be 25º on the right side and 20º on the left side, which was beyond the physiological normal angulation, therefore he was diagnosed as a case of Blount´s disease, stage III as per Langenskiöld classification. All the bow legs is not always rickets in pediatric practice. Therefore, various differential diagnoses should be kept in mind as early diagnosis and intervention can change a child´s life.

BACKGROUND: The purpose of this case study was to identify factors of bilateral etiopathogenesis of Osgood-Schlatter disease (OSD) and those supporting the effectiveness of the therapeutic process in a 12-year-old elite female Olympic karateka.
METHODS: The present case study concerns OSD female karateka who started her sport-specific training at the age of 4 years.
METHODS: The results of subjective palpation by the orthopedic surgeon and objective medical examination using ultrasonography, wall slide test, magnetic resonance imaging, and body height and weight measurements were collected.
METHODS: The therapeutic intervention for the athlete\'s knee joints lasted 20 months (5 stages). Physical therapy, kinesiotherapy, and pharmacological treatment were administered, and physical activity was gradually introduced.
RESULTS: The developmental trajectory was uniform for body height and labile for body weight. OSD was diagnosed after the second growth spurt, and significant progression was reported during the subsequent height and weight gains and increased volume and intensity of sports training. The rate and dynamics of changes in the distance from the patellar ligament to the tibial apophysis were irregular, with dominance in the right knee with the highest rate of change (-3.3 mm) and twice the regression of the rate of change (-2.5 mm). The analyzed distance never exceeded the baseline value (5.5 mm), which was the case in the left knee. Return to sports competition was possible from the second month of therapy, in which kinesiotherapy and static stretching were the most effective. A relatively correct distance of the patellar ligament from the tibial apophysis was recorded at the time of stabilization of the body height and weight gain. No pathological changes were observed following OSD, and full recovery was observed.
CONCLUSIONS: In the case discussed in this study, growth spurt, the specificity of the sport practiced, and early specialization including high-volume and high-intensity training should be considered as factors causing OSD and its progression. Kinesiotherapeutic management and static stretching are crucial for the treatment of OSD. Quick return to sports competition was possible due to early therapeutic intervention, which could also lead to the absence of pathological changes in the tibial tubercle and the absence of recurrence of OSD.

UNASSIGNED: Osteochondrosis of humeral capitellum (Panner\'s disease) is a rare condition. Very few cases are reported in the literature and may be overlooked or misdiagnosed. Most cases are unilateral in distribution and occur in young boys during the first decade of life. It is often difficult to distinguish osteochondrosis from osteochondritis dissecans of the humeral capitellum that occurs in older children and adolescents in the second decade of life.
UNASSIGNED: We describe a case of a 6-year-old boy who presented with pain, subtle swelling and limited extension in his right elbow following a fall. Diagnosis of Panner\'s disease was made 2 weeks later on follow-up based on classical features on plain radiograph of joint effusion, irregular delineation of the articular contour, and faint sclerosis of the capitellum with a radiolucent line in the subchondral bone. The patient had uneventful full functional recovery with conservative treatment: Rest, temporary immobilization, and subsequent remobilization.
UNASSIGNED: Osteochondrosis of humeral capitellum though rare is a known condition. It may be overlooked or misdiagnosed. High degree of awareness is required and diagnosis can be made with utmost care based on the age of presentation, clinical signs and clearly recognizable plain radiographic features of joint effusion, irregular articular outline with radiolucent line in subchondral bone and faint sclerosis of capitellum.