Prevalence of osteochondritis among preparatory and primary school children in an Egyptian governorate.

Epiphyseal osteochondritis is a localized disorder in childhood. Vascular insufficiency is thought to be the most significant etiologic factor. This study had been carried on Primary and Preparatory school children in Zagazig City and surrounding villages in Sharkia Governorate, Egypt. Total number of studied children were 16,060, 7,380 males, 8,680 females. The mean age was 11.41 ± 1.99. Our results showed that the prevalence of osteochondritis was 21:10,000. Distribution of Sever's and Osgood-Shlatter diseases were significantly high compared with other osteochondritis. Regarding the sex distribution, osteochondritis was frequent in males. Our results showed that there was history of trauma especially in Sever's and Osgood-Schlatter diseases.

Early changes in biomarkers of skeletal metabolism and their association to the occurrence of osteochondrosis (OC) in the horse.

REASON FOR PERFORMING STUDY: Diagnosis of osteochondrosis (OC) is based on clinical signs and radiography, but alternative methods for detection at an early stage would be useful. OBJECTIVES: To determine in the juvenile horse the relationship between serum concentrations of a number of biomarkers that reflect changes in cartilage and bone turnover and age, feeding level, growth, and the occurrence of OC. METHODS: Foals were assigned to a high (n = 20) or moderate (n = 19) feeding level group from birth to age 1 year. Bodyweight, withers height and cannon width were measured. Osteoarticular status was assessed radiographically at 5.5 and 11 months in all foals, and by necropsy at 12 months for 8 foals/group. Serum biomarkers of bone (osteocalcin, CTX-1) and cartilage (CPII, C2C) metabolism were assayed at 8 time points between ages 2 and 52 weeks. Ratios between biomarkers of tissue formation and degradation were calculated at each time point. RESULTS: Consistent age-related patterns in biomarker serum concentrates were found, indicating a markedly higher metabolism before age 20 weeks but concentrations were not affected by feeding level. Bodyweight was correlated negatively to C2C and CTX-1, and withers height was positively correlated to osteocalcin and the osteocalcin/CTX-1 and CPII/ C2C ratios. Osteocalcin concentration at 2 weeks and CPII/ C2C ratio at 20 weeks had strong positive correlations to OC, as diagnosed radiographically at 5.5 months. Osteocalcin had a strong correlation with radiographically detected OC at 11 months but at that time there was no significant relationship between CPII/C2C ratio and OC. CONCLUSIONS: Occurrence of OC lesions is significantly associated with anabolic changes in bone metabolism during the first weeks post partum, given the strong relation with osteocalcin. POTENTIAL RELEVANCE: Measuring osteocalcin concentrations during the first few weeks post partum may have potential value for the prediction of risk for OC development.

Pain in Osteochondral Lesions of the Ankle - an Investigation Based on Data from the German Cartilage Registry (KnorpelRegister DGOU).

BACKGROUND: The aim of the study was to investigate parameters influencing the preoperative pain intensity in patients with osteochondral lesions of the ankle. The evaluation covered patient-related parameters such as age, sex, body mass index (BMI), as well as defect-related parameters, such as localisation, size and stage (according to the classification of the International Cartilage Repair Society [ICRS] and the Berndt-Harty-Loomer classification). We also examined the correlation between the different surgical techniques and additional factors, such as debridement of an impingement or stabilisation of the ankle on the one hand, and the preoperative pain intensity on the other. MATERIAL AND METHODS: 259 patients with osteochondral lesions of the ankle were operated in 32 clinical centres between October 2014 and December 2016 and enrolled consecutively in the German Cartilage Registry (KnorpelRegister DGOU). 151 patients were available for analysis. The preoperative pain intensity was assessed at the time of surgery with online questionnaires, using the Numeric Rating Scale for pain (NRS). RESULTS: The median preoperative pain intensity in the complete study population (n = 151) was 3 (range 0 - 10). There was no correlation between the age and the preoperative pain intensity (ρ = - 0.06). Further, there was not detected a difference between the two genders according to the preoperative pain intensity (p = 0.31). In female patients a higher BMI correlated with a higher preoperative pain intensity (ρ = 0.16). Within the group of patients with a solitary treated talus lesion there was no difference according to the preoperative pain intensity between the different localizations of the defect (medial vs. lateral talus) (p = 0.82). Within the group of patients with a solitary treated talus or tibia lesion there was no correlation between the defective area or the lesion stage according to the ICRS classification on the one hand, and the preoperative pain intensity on the other (ρ = 0.09, and ρ = 0.04, respectively). According to the Berndt-Harty-Loomer classification a higher lesion stage (stage four and five) was associated with a higher preoperative pain intensity (ρ = 0.13). There was no difference according to the preoperative pain intensity between the group of patients that received a debridement of a bony or soft tissue impingement in addition to the cartilage therapy and the group of patients without this kind of additional therapy (p = 0.10). Further, there was no difference according to the preoperative pain intensity between the group of patients that received a stabilisation of the ankle joint in addition to the cartilage therapy and the group of patients without a stabilisation procedure (p = 0.83). CONCLUSION: Osteochondral lesions of the ankle can be associated with a moderate and in some cases high pain intensity. In female patients a higher BMI is associated with a higher pain intensity. Further, a higher lesion stage according to the Berndt-Harty-Loomer classification is associated with a higher pain intensity, which highlights the clinical relevance of this classification.

[Prevalence of hereditary diseases in three-year-old Swiss Warmblood horses]. / Erhebung der Prävalenz von Erbkrankheiten bei dreijährigen Schweizer Warmblutpferden.

The objective of this study was to investigate clinical signs indicating hereditary diseases like equine sarcoid, osteochondrosis (OC) and the idiopathic laryngeal hemiplegia (ILH), and to demonstrate relationships between environment, feeding habits and conformation ("exterieur" evaluation) of the horses. For this purpose, we analyzed veterinary examinations of 403 stallions at the approvals since 1994 examined 493 three-year-old Swiss Warmblood horses, which were shown at the Swiss-Field-Tests in 2005. With the help of the owners a questionnaire on health, environment and feeding habits of the animals was completed. At the same time, the horses were assessed and graded for their "exterieur" (type, conformation, gaits) by judges of the Swiss Sporthorse breeding association. In 11.5% of horses sarcoids were found, 8.7% showed one and 2.8% several tumors. The prevalence of sarcoids in offspring of sires with known sarcoids was not significantly higher than in descendants from stallions without a known history of sarcoids. We found distended joints as a possible symptom of OC in 11.4% of the horses, 3.9% (n = 19) in both tarsal joints. We did not find a relationship between enlarged joints in the offspring and the presence of OC in the sires. Abnormal respiratory noise at work, as a possible sign for ILH, was heard only in 1.2% (n = 6). It is important to note that while we found a high number of sarcoid affected horses compared to other studies, presence of enlarged joints was not very frequent and very few horses showed abnormal respiratory noise. Additionally, we found no correlation between "exterieur" marks and the horse's general health.

Lameness and fertility of sows and gilts in randomly selected loose-housed herds in Finland.

The prevalence of lameness among 646 sows and gilts in 21 selected herds was determined; 8.8 per cent of the animals were lame and the most common clinical diagnoses were osteochondrosis, infected skin lesions and claw lesions. The lame animals had higher serum concentrations of haptoglobin and C-reactive protein than the sound animals. Animals housed on slatted floors had twice the odds of being lame and 3.7 times the odds of being severely lame than animals housed on solid floors. Yorkshire pigs had 2.7 times the odds of being lame than Landrace or crossbred animals. Higher parity and the use of roughage decreased the odds of the sows not becoming pregnant; however, lameness was not a risk factor for non-pregnancy.

Osgood-Schlatter's disease in adolescent athletes. Retrospective study of incidence and duration.

During the period of 1976 to 1981, a total of 412 young athletes contacted the Turku Sports Medical Research Unit's (TSMRU) Outpatient Sports Clinic with 586 complaints. These records included 68 athletes with Osgood-Schlatter's disease (OSD), who were initially prescribed an average of 2 months' rest from any physical activity causing pain. Symptoms of tibial tuberosity pain occurred first at the average age of 13.1 years. According to the retrospective questionnaire, the pain caused complete cessation of training for an average of 3.2 months, and the disease interfered with fully effective training for an average of 7.3 months. According to a retrospective questionnaire given to 389 students (191 girls and 198 boys), 50 (12.9%) had suffered from OSD. Nearly one-half of the students, 193 (49.6%), had been active in sports at the age of 13, and 41 (21.2%) of them had suffered from OSD. In those students who were not active in sports, the incidence was only nine (4.5%; P less than 0.001). The incidence (32%) was higher in the siblings of the OSD patients of TSMRU who were active in sports than in the corresponding student group (21.2%). In a group of 22 patients from the TSMRU who had suffered from Sever's disease (calcaneal apophysitis), the incidence of OSD (68%) was significantly higher than in students who were active in sports (P less than 0.001).

A review of the salient features of osteochondrosis in the horse.

There appears to be an increasing incidence of osteochondrosis in young fast-growing horses in Europe and the USA. The disease is thought to be congenital in type and affects endochondral ossification in growing bones. It can be localised to one joint or may be a generalised condition. The clinical manifestations of the disease lead to a secondary chronic degenerative joint disease in adult animals. There is a genetic predisposition to the condition which is associated with rapid growth and excessive high energy feeding. The careful genetic selection of bloodstock and restricted intake in early life can greatly assist in decreasing the incidence of the disease.

Effect of reduced growth rate on the prevalence and severity of osteochondrosis in gilts.

Ninety-six recently weaned gilts were assigned to 3 groups. Group-1 gilts were fed a corn-soybean meal diet ad libitum and were killed when they weighed 110 kg. Gilts in groups 2 and 3 were fed 70% of the feed consumed by group-1 gilts. Group-2 gilts were killed when they weighed 110 kg, and group-3 gilts were killed at the same age as group-1 gilts. At slaughter, the right pelvic and thoracic limbs from all gilts were removed, and the distal end of each femur and humerus was sectioned serially at 5-mm intervals. Articular-epiphyseal cartilage complexes from these sites were examined grossly, radiographically, and histologically. Effects of treatment (ad libitum vs limited energy intake) and average daily gain on the prevalence and severity of lesions were analyzed statistically, using chi 2 analysis, a categoric-modeling technique, analysis of variance, and correlation coefficients. Of humeri and femora, 49 and 70%, respectively, had lesions of osteochondrosis, and 86% of the gilts had a lesion at one or both sites. Group-2 gilts (killed at 110 kg, but approx 70 days older than group-1 gilts) had significantly lower prevalence (P = 0.009) and severity (P = 0.002) of osteochondrosis of the distal end of the femur than did gilts in groups 1 and 3. When each group was evaluated individually, gilts that had a higher average daily gain had an increased prevalence and severity of lesions.

Spontaneous osteochondrosis in rats.

143 Sprague Dawley rats, ranging from 19-63 weeks of age, were examined pathologically for the occurrence of spontaneous joint lesions. Macroscopically, a white round plaque was observed in the caudocentral portion of the medial femoral condyle or humeral head and sometimes it had a partially detached margin. Microscopic examination revealed a local thickening of the articular cartilage protruding into the subchondral bone, which suggested cessation of endochondral ossification and retention of cartilage. As the lesion advanced there was fissure formation in the thickened cartilage and proliferation of fibrous tissue beneath the fissure. Formation of a cartilage flap and extensive fibrosis with large cysts were also observed in the most advanced cases. Total incidence of the lesion in the distal femur was 22.2% in male and 2.8% in female rats. The change detected in the rats was identical with pathologic descriptions of osteochondrosis in domestic animals.

Anatomical risk factors for Kienböck's disease.

Contralateral unaffected wrists from 41 males with Kienböck's disease were compared with wrists from 66 normal males. From X-rays, various features of the lunate and radius were measured. In patients with Kienböck's disease, the lunate tended to be smaller and inclined more radially than in normal subjects and the radial inclination was flatter. Discriminant analysis showed that 85% of the unaffected contralateral wrists in patients with Kienböck's disease and 74% of the wrists in normal subjects were accurately discriminated to their respective groups. It may be possible to identify subjects who are at risk for Kienböck's disease prior to onset using discriminant analysis.

Kienböck's disease in women.

We examined 133 patients with Kienbock's disease, five of whom had bilateral disease. There were 47 women and 86 men. The mean age of patients was 42.7 years (range, 14-80 years). The frequencies of involvement of the right and left sides were approximately equal for women, but male patients tended to have right wrist joint involvement. The side of the affected wrist in the female group differed significantly from that in the male group. The age at onset for women was significantly higher than that for men. The percentage of manual workers was significantly lower among women than among men. The characteristics of Kienböck's disease in women differed from those in men and those previously reported for this disease. These findings suggest that the pathogenesis of Kienböck's disease in women differs from that in men.

Heritability estimations of osteochondrosis in the tibiotarsal joint and of bony fragments in the palmar/plantar portion of the metacarpo- and metatarsophalangeal joints of horses.

Radiography of the tibiotarsal and metacarpo- and metatarsophalangeal joints was performed on 753 Standardbred trotters (6 to 21 months old) born in 1988. The surveyed population was drawn at random from all parts of Norway and represented about 60% of Standardbred trotters born the same year. Osteochondrosis in the tibiotarsal joint was diagnosed in 108 (14.3%) horses, and the prevalence of disease in progeny groups > 10 ranged from 0 to 69%. Bony fragments in the palmar/plantar portion of the metacarpo- and metatarsophalangeal joints were diagnosed in 89 (11.8%) horses, and the prevalence of disease in progeny groups > 10 ranged from 0 to 41%. Heritability analysis was restricted to 644 horses, comprising groups of 5 or more progeny, from 39 stallions. The heritabilities of osteochondrosis in the tibiotarsal joint and of bony fragments in the palmar/plantar portion of the metacarpo- and metatarsophalangeal joints were estimated to be 0.52 and 0.21, respectively, using a nonlinear model.

Osteochondrosis in cattle.

Osteochondrosis is a poorly understood condition that affects many species, including cattle. Its incidence is not fully appreciated in the cattle industry for many reasons. Most of the reports show a male, purebred predilection, but this may simply be a result of the typical population for which medical attention is sought. With the increasing value of female breeding stock, a less skewed distribution of the disease will most likely result. Distribution of lesions is similar to that in the horse, with the stifle and tarsus most commonly affected. Treatment is divided into medical and surgical options, but neither seem to be strikingly effective as of yet. Surgical techniques include arthroscopy and arthrotomy, and both have their complicating factors. How osteochondrosis as a disease will affect the cattle industry is still to be decided. If the incidence rate does increase with more animals being valued for their economic potential, then treatment options will surely be reevaluated and refined.

Arthroscopic removal of palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarso-phalangeal joints of standardbred trotters--outcome and possible genetic background to POF.

A clinical material of 133 Standardbred horses with palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarsophalangeal joints were studied. All horses had their fragments removed with arthroscopic surgery. 102 of the horses were 3 years old or younger when surgery was performed. Anatomical localisations of the fragments were in agreement with earlier reports. There was no statistical significant difference in month of birth in the POF--group compared to the total population. Eighty % of the horses that had raced before surgery came back to racing. The racing performance relative to their contemporaries remained the same after the POF operation. 65% of the horses that had not raced before surgery raced after the operation. The breeding index BLUP (Best Linear Unbiased Prediction) was used to evaluate if the POF-horses differed genetically in racing ability from the total population. The average BLUP value of the POF group was 103.4 (+/- 0.65), while the mean BLUP value of the total population was 98.9. This difference was highly significant and indicated that these POF horses belonged to a selected group. A homogeneity test of allele frequencies in blood type systems was performed to evaluate if any genetic difference was persistent between POF horses compared to the total population. The statistical analysis of gene frequencies for alleles in blood type systems indicated a genetic discrimination in blood type systems D and Tf.

Osteochondrosis in wild boar-Swedish Yorkshire crossbred pigs (F2 generation).

Osteochondrotic lesions occur in very high frequency in growing pigs of all commercial breeds and are claimed to be associated with high growth rate, and not to occur, or to be milder, in slow-growing pigs. The present study monitored the magnitude and distribution of osteochondrotic lesions in a crossbred pig population of wild boar and Swedish Yorkshire ancestry. In this population, having a low growth rate, the distribution and extent of osteochondrotic lesions was similar to that of purebred Swedish Yorkshire pigs, and only weak relationships between the studied growth parameters and osteochondrosis could be found.

[Problems in diagnosis of vibratory articular skeletal syndrome]. / Problemy diagnostyczne postaci kostno-stawowej zespolu wibracyjnego.

Vibratory syndrome is still one of the essential problems in occupational health care. A literature review indicates that the majority of studies focus on vascular changes with very limited data on radiological articuloskeletal changes. Non-acute disease manifestation and the lack of clear-cut radiological criteria of skeletal changes contribute to diagnostic problems. The situation presented cannot be accepted as satisfactory in terms of certification consequences at the individual and population levels. There is a need to continue epidemiological studies which should allow for developing diagnostic criteria formulated in a simple way, as well as quantitative and qualitative rating of radiological skeletal changes.

[Static changes of the spine in workers in the automobile industry]. / Zmiany statyczne kregoslupa u pracowników zakladów samochodowych.

In 13 year period of time 28.324 x-ray examinations of spine performed in workers of Jelcz's car-factory revealed a high percentage (22.5%) of vertebral epiphysitis (Scheuermann's Disease) and scolioses (9.95%) among adolescents aged 17-21 years applying for work in the factory. The statistical analysis of this material has shown that vertebral epiphysitis passed by persons at the age below 40 years has contributed to static changes in spine more significantly than the character of work performed. The greatest number of scolioses among workers aged over 40 years was noted in: tinsmiths, pressers and welders--i.e. the jobs exposing the spine to the highest loads. In those professional groups periodical examinations are recommended to detect early symptoms of scolioses.

[The course of neurological manifestations of lumbar osteochondrosis and the quantitative assessment of prognostically significant factors]. / Techenie nevrologicheskikh proiavlenii poiasnichnogo osteokhondroza i kolichestvennaia otsenka prognosticheski znachimykh faktorov.

On the basis of computer-assisted processing of an archive of formalized histories of 2187 patients with neurological manifestations of lumbar osteochondrosis the author has revealed a number of regularities characterizing the time-course of this disease. A comparative quantitative assessment of the prognostic value of a number of history, clinical and paraclinical parameters is presented. Tabulated and computerized systems predicting the course of the disease in a given patients are described. Data obtained during 1-3 year long follow up are presented.

[The mineral element content of the blood in healthy persons living in regions of endemic goiter and Urov (Kashin-Bek) disease]. / Soderzhanie nekotorykh mineral'nykh élementov v krovi zdorovykh liudei, prozhivaiushchikh v raionakh zobnoi i urovskoi (bolezni Kashina--Beka) éndemii.

Atomic-absorption spectrophotometry was used to study blood sera of 135 healthy people aged 18 to 60 years, living under the conditions of continental climate with trace elements and iodine deficiency in the environment. The changes in the content of minerals in the peripheral blood were discovered to be related to the age, characterized in most cases by a decrease of their content with age. The data given in the paper confirm the reduction of trace elements to the lower limits of normal in all the age groups living in the Western regions of this country.