title: Multiple osteochondroses of bilateral knee joints: a case report.
abstract: Knee injuries in young athletes include not only the typical adult bone injuries, ligament and cartilage, but also the growth plate lesions. Osteochondroses are idiopathic, self-limited disturbance of enchondral ossification in which a rapid growth spurt is present. The patella could be affected by two different kinds of osteochondroses: Kohler syndrome and Sinding-Larsen-Johansson. Here we are reporting the first case of simultaneous location of osteochondroses of the two ossification centers of both patella. A 9-year-old boy, competitive skater, presented a history of anterior knee pain involving both knees. Standard X-rays, axial patellar view, MRI and arthro-MR were performed. In order to follow the natural history of the pathology and the evolution of the healing, examinations at 2 years were repeated. We proposed the young skater a medical and a physiotherapeutic treatment based on unloading, isometric exercises, NSAID. As the symptoms improve a gradual return to competitive sports activity was allowed. The case mentioned above can be considered an atypical case because the patient suffered for a bilateral knee osteochondroses, involving simultaneously the primary ossification centre (Kohler syndrome) and the secondary ossification centre (Larsen syndrome) of the patella.
authors.affiliation: Department of Orthopaedic surgery, University Campus Biomedico of Rome, via E. Longoni, N. 83, 00155, Rome, Italy. f.franceschi@unicampus.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.forename: Simona Angela
authors.initials: SA
authors.lastname: Barnaba
authors.forename: Mario
authors.initials: M
authors.lastname: Rojas
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Gualdi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Rizzello
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D001182:Arthroscopy; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007719:Knee Joint; D008279:Magnetic Resonance Imaging; D008297:Male; D010007:Osteochondritis / Q000175:diagnosis* / Q000534:rehabilitation*; D010329:Patella / Q000473:pathology; D026741:Physical Therapy Modalities; D014057:Tomography, X-Ray Computed