[Pediatric arthroses as a sequelae of enchondral damage. Examples of frostbite, Kashin-Beck disease, rat bites and other etiologies].
OBJECTIVE
To review the similarities of the radiographic changes in frostbite, the Asian disease of Kashin-Beck, and long term growth damage from injury such as rate bite.


METHODS
Radiographs and literature from subjects with these diagnoses were analyzed for the common features and differences. Included was an infant with hand changes 8 months after unwitnessed rat bites.


RESULTS
Each condition revealed findings consistent with the hypothesis of localized damage to sites of enchondral ossification, including at acrophyses--the growth plates that are not between epiphysis and metaphysis, but instead lie at the margins of growth centers, including carpal and tarsal bones, and the non-epiphyseal ends of small tubular bones.


CONCLUSIONS
The patterns observed support a final common pathway of damage in frostbite due to cold injury, Kashin-Beck disease (endemic in China) of unknown etiology, and damage from toxins associated, for example, with rat bite. In frostbite, the distribution is acral because of the site of exposure, while the distribution in Kashin-Beck is more diffuse and often less contiguous. In each condition, arthrotic sequelae may be expected in the natural course of follow-up. MRI may play a role in acute diagnosis that might modify the course of each disease.
Oestreich
A E
AE
Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, Ohio, USA. oestreich.ae@chmcc.org
D000818:Animals; D001175:Arthrography; D001733:Bites and Stings / Q000150:complications* / Q000000981:diagnostic imaging; D001848:Bone Diseases, Developmental / Q000000981:diagnostic imaging / Q000209:etiology; D002357:Cartilage Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005627:Frostbite / Q000150:complications* / Q000000981:diagnostic imaging; D006132:Growth Plate / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007596:Joints / Q000473:pathology; D008297:Male; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology*; D051381:Rats; D000072042:Salter-Harris Fractures
Kindliche Arthrosen als Folge enchondraler Schädigungen. Am Beispiel von Erfrierungen, der Kashin-Beck-Erkrankung, Rattenbissen und anderen Ursachen.