Basic HTML Version
251
Ν. Κοτζιαμάνη και συν. Παρουσίαση περιστατικού με νόσο του Blount: ο ρόλος της μαγνητικής τομογραφίας στη διερεύνηση της
εξαρτάται από το στάδιο της νόσου και την ηλικία του
παιδιού κατά τη χειρουργική αποκατάσταση
30
.
ABSTRACT
Kotziamani N, Chaitidou S, Koutsampasopoulou
I, Panagiotidou D, Kariki E, Tsitouridis I.
A case of
Blount’s disease: MRI evaluation
Blount’s disease is a developmental disorder
characterized by relative growth inhibition of the
posteromedial portion of the proximal aspect of the
tibia. The pathogenesis of the deformity is likely related
to excessive compressive forces on the medial aspect
of the proximal tibial physis. There is an increasing
deformity of the medial tibial plateau with progressive
depression and fragmentation of the medial tibial
metaphysis, also involving the epiphysis in higher
stages and bone bridge formation between the tibial
epiphysis and metaphysis in end stage disease. MRI
is an excellent imaging tool, superior to other imaging
methods, providing useful informations about the
physis and the cartilaginous part of medial epiphysis.
Mechanical alignment must be restored before skeletal
maturity to reduce the risk of early onset degenerative
changes.
Keywords:
Blount’s disease, tibia vara, growth inhibition
of the physis, MRI.
ΒΙΒΛΙΟΓΡΑΦΙΑ
1. Resnick D. Diagnosis of bone and joint disorders, 3rd ed.
Philadelphia: WB Saunders, 1995:3589.
2. Blount WP. Tibia vara. Osteochondrosis deformans tibiae. J
Bone J Surg 1937;19:1–29.
3. Erlacher P. Deformierende Prozesse der Epiphysengegend bei
Kindern. Arch Orthop Unfallchir 1922; 20:81–96.
4. Sabhanwal S, Zhao C. McCiemens E. Correlation of body mass
index and radiographic deformities in children with Blount disease.
J Bone Joint Surg Am 2007; 89:1275-1283.
5. Hofmann A, Jones RE, Herring JA. Blount's disease after skeletal
maturity. J Bone Joint Surg Am 1982; 64:1004-1009.
6. Ingvarsson T, Hagglund G, Ramgren B, Jonsson K, Zayer M.
Long-term results after adolescent Blount's disease. J Pediatr
Orthop B 1997; 6:153-156.
7. Zayer M. Osteoarthritis following Blount’s Disease. Int Orthop
1980; 4:63-66.
8. Cheema JI, Grissom LE, Harcke HT. RadioGraphics 2003;
23:871-880
9. Ferguson J, Wainwright A. Tibial bowing in children. Orthopaedics
and Trauma 2013;27(1):30-41.
10. Sabharwal S. Blount disease. J Bone Joint Surg Am 2009;
91:1758-1776.
11. Loder RT, Johnson CE. Infantile tib ia vara. J Pediatr Orthop
1987; 7:639-646.
12. Wenger DR, Mickelson M, Maynard JA. The evolution and
histopathology of adolescent tibia vara. J Pediatr Orthop 1984;
4:78-88.
13. Langenskiöld A. Tibia vara: osteochondrosis deformans tibiae.
Blount's disease. Clin Orthop 1981;158:77-78.
14. Sevastikoglou JA, Eriksson I. Familial infantile osteochondrosis
deformans tibiae. Idiopathic tibia vara. A case report. Acta
Orthop Scand 1967; 38: 81-87.
15. Τοlo VT, The lower extremity. In: Morrissy RT, Weinstein SL,
eds. Lovell and Winter’s pediatric orthopaedics. Vol II. 4th ed.
Philadelphia, Pa: Lippincott-Raven, 1996; 1047-1075.
16. Levine AM, Drennan JC. Physiological bowing and tibia vara.
Themetaphyseal-diaphyseal angle in themeasurement of bowleg
deformities. J Bone Joint Surg Am 1982; 64:1158-1163.
17. Feldman MD, Schoenecker PL. Use of the metaphyseal-
diaphyseal
18. angle in the evaluation of bowed legs. J Bone Joint Surg Am
1993; 75: 1602-1609.
19. Davids JR, Blackhurst DW, Allen Jr BL. Radiographic evaluation
of bowed legs in children. J Pediatr Orthop 2001; 21: 257-
263.
20. Langenskiöld A. Tibia vara (osteochondrosis deformans tibiae).
Acta Chir Scand 1952; 103:1–22.
21. Catonne Y, Pacault C, Azaloux H, Tire J, Ridarch A, Blanchard
P Aspects radiologiques de la maladie de Blount. J Radiol
1980; 61:171-176.
22. Sabharwal S, Lee J Jr, Zhao C. Multiplanar deformity analysis
of untreated Blount disease. J Pediatr Orthop 2007;27(3):260-
265.
23. Craig JG. van Holsbeeck M, Zaitz L The utility of MR in assessing
Biount disease. Skeletal Radiol. 2002; 31:208-213.
24. Ducou le Pointe H, Mousselard H, Rudelli A, Montagne J-P,
Filipe G. Blount’s disease: magnetic resonance imaging. Pediatr
Radiol 1995; 25:12–14.
25. Doyle BS, Volk AG, Smith CF. Infantile Blount disease: long-
term follow up of surgically treated patients at skeletal maturity.
J Pediatr Orthop 1996; 16:469–476.
26. Trueta J, Trias A. The vascular contribution to osteogenesis.
IV. The effect of pressure upon the epiphysial cartilage of the
rabbit. J Bone Joint Surg Br 1961;43:800-813.
27. Kline SC, Bostrum M, Griffin PP. Femoral varus: an important
component in late-onset Blount’s disease. J Paediatr Orthop
1992; 12: 197-206.
28. Aird JJ, Hogg A, Rollinson P. Femoral torsion in patients with
Blount’s disease: a previously unrecognised component. J Bone
Joint Surg 2009; 91: 1388-1393.
29. Gordon JE, Heidenreich FP, Carpenter CJ, Kelly-Hahn J,
Schoenecker PL. Comprehensive treatment of late-onset tibia
vara. J Bone Joint Surg Am 2005; 87: 1561-1570.
30. Richards BS, Katz DE, Sims JB. Effectiveness of brace treatment
in early infantile Blount’s disease. J Pediatr Orthop 1998; 18:
374-380
31. Nunn T, Rollinson P, Scott B. Blount’s disease. Orthopaedics
and Trauma 2011, Vol. 25 (6): 454-461.