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PubMed1975

Neonatal septic "dislocation" of the hip: true dislocation or pathological epiphyseal separation?

The clinical and roentgenologic appearance of septic dislocation of the hip may be caused by either a true dislocation or a pathological epiphyseal separation due to osteomyelitis. Arthrography of the hip permits differentiation in the neonate. The significance of these two anatomical possibilites is discussed in terms of follow-up and results of neonatal infections about the hip, and a case of pathological epiphyseal separation at the hip diagnosed in the neonatal period by aspiration and arthrography and followed up for 3 years is presented.

Child, Preschool↗
PubMed1998

Pediatric endocrinology update: an overview. The essential roles of estrogens in pubertal growth, epiphyseal fusion and bone turnover: lessons from mutations in the genes for aromatase and the estrogen receptor.

The goals of this presentation are to review the essential roles of aromatase, estrogens and the estrogen receptor in pubertal growth. Estrogen deficiency due to mutations in the aromatase gene (CYP19) and estrogen resistance due to disruptive mutations in the estrogen receptor gene have no effect on normal male sexual maturation in puberty. However, they lead to absence of the pubertal growth spurt, delayed bone maturation, unfused epiphyses, continued growth into adulthood and very tall adult stature in both sexes. Gonadotropin and androgen levels are elevated in patients with either estrogen deficiency (aromatase deficiency) or estrogen resistance (estrogen receptor mutation). Glucose intolerance, hyperinsulinemia and lipid abnormalities are also present. Skeletal integrity is compromised. Increased bone turnover, reduced bone mineral density and osteoporosis develop in both sexes. Sexual orientation is appropriate in males and females. In females, aromatase deficiency in the ovary causes pubertal virilization and multicystic ovaries because of elevated gonadotropins and androgens. Simultaneously, secondary sexual maturation fails to occur. Placental aromatase deficiency results in virilization of the mother and her female fetus because of the accumulation of potent androgens which are not converted to estrogens. The male fetus has normal genitalia. In conclusion, estrogens are essential for normal female secondary sexual maturation, bone maturation, epiphyseal fusion, pubertal growth spurt and achievement of normal bone mineral mass. Estrogens also influence insulin sensitivity and lipid homeostasis. However, estrogens do not appear to be essential for fetal survival, placental growth, or female sexual differentiation.

Adult↗
PubMed1980

Comparative histological study of the effects of high calcium diet and vitamin D supplements on epiphyseal plates of vitamin-D-deficient chicks.

A comparative histological and microradiographic study of the tibial epiphyseal plates of chickens raised on: (1) a vitamin-D-deficient diet; (2) a vitamin-D-deficient diet supplemented with cholecalciferol, and (3) a vitamin-D-deficient diet to which extra calcium had been added, has revealed that a high-calcium diet did not normalize the epiphyseal plates completely. However, it restored the normal length and chondrocyte arrangement to the proliferative zone. The degenerative zone became elongated and this seems to be related to the hypophosphataemic condition which has developed as a result of the special diet.

Animals↗
PubMed1977

Sequence of eruption of permanent teeth and epiphyseal union in three species of African monkeys.

Sequences of eruption of teeth and union of epiphyses determined for three species of African Cercopithecinae. These sequences are highly scalable and are highly comparable between among the species. Some sex differences in sequence were found within each species. The sequences of epiphyseal union in these species of Old World monkeys are very similar to published sequences in New World monkeys and other groups of higher primates. It appears that there is a single pattern common to the Anthropoidea as a whole.

Age Factors↗
PubMedDate not supplied

Studies on hypoxia: XII. Detrimental effects of synthetic polyribonucleotides on epiphyseal plates of rats exposed to hypoxia.

The effect of different doses of polyadenylic and polyuridylic acids (poly A:U) was studied in control rats and in rats exposed to hypoxia. In the control rats, administration of different doses of poly A:U did not change the thickness of the epiphyseal plate or increase the incorporation of 3H-phenylalanine as judged using radioautography. Rats exposed to hypoxia showed a significant dose-related reduction in the thickness of the epiphyseal plate and 3H-phenylalanine incorporation.

Amino Acids↗
PubMed1983

Ultrastructural cytochemistry and immunocytochemistry of proteoglycans associated with epiphyseal cartilage calcification.

Proteoglycans (PGs) are closely associated with cartilage calcification. We have examined the hypertrophic zone of rat epiphyseal cartilage, in which calcification is occurring, using the high-iron diamine-thiocarbohydrazide-silver proteinate (HID-TCH-SP) method for sulfated glycosaminoglycans, an immunoferritin method specific for chondroitin sulfate A, and the tannic acid-ferric chloride (TA-Fe) method to stain cartilage matrix granules (MGs) presumed to be PG monomers. HID-TCH-SP produced stain deposits with a diameter of 11.2 +/- 3.2 nm (mean +/- SD; n = 200) in the MGs. However, HID-TCH-SP staining was not discernible in membrane-limited matrix vesicles (MVs). In areas of advanced calcification, partially disrupted MVs and globular bodies (GBs), derived in part from disrupted and/or degenerated MVs, contained a few too many small HID-TCH-SP stain deposits. Further down the epiphyseal cartilage, intact MVs markedly decreased and the GBs, containing many small HID-TCH-SP stain deposits, significantly increased in number. These GBs were found exclusively in the longitudinal septa rather than in the transverse septa. After enzyme digestion with testicular hyaluronidase, small (7.2 +/- 1.2 nm in diameter) stain deposits remained in the MGs and GBs, presumably localized to keratan sulfate. Immunoferritin localizing chondroitin sulfate strongly stained MGs, whereas MVs and GBs lacked staining. TA-Fe staining of glycoconjugates in the GBs demonstrated a striking decrease in the diameter of MGs associated with calcification in the GBs as compared with those in the noncalcifying area around the GBs. These results indicate that the GBs containing needle-like apatite crystals in morphologic preparations represent sites of chondroitin sulfate degradation. Testicular hyaluronidase-resistant sulfated glycosaminoglycans presumed to be keratan sulfate and partially degraded PGs selectively remain within the GBs as a probable requisite for expansion of the initial calcification in MVs.

Animals↗
PubMed1983

Specific binding of growth hormone to isolated chondrocytes from rabbit ear and epiphyseal plate.

Chondrocytes were isolated from rabbit ear, epiphyseal and rib cartilage, and their ability to bind 125I-labeled human growth hormone (hGH) was investigated. The total binding of hormone to ear chondrocytes increased with time until 4-6 h, whereas non-specific binding did not increase. Total binding was 1-3% of total counts added, and non-specific binding was 10-20% of total binding. Unlabeled hGH, bGH and oPRL competed with the binding of labeled hGH in a dose-dependent manner with half-maximal binding at concentrations of 10-20 ng/ml (hGH) and 100 ng/ml (bGH and oPRL). The two latter hormones displaced almost all specific binding of hGH at higher concentrations. Ear chondrocytes from newborn to 4 week old rabbits all showed specific binding of hGH with no clear age dependence. Rib chondrocytes, on the other hand, showed very little specific binding. Epiphyseal chondrocytes from newborn animals yielded intermediate binding values. The finding of specific hGH binding by cultured chondrocytes supports the concept of a direct effect of GH on chondrocytes.

Animals↗
PubMed1986

Limb lengthening by distraction of the epiphyseal plate. A comparison of two techniques in the rabbit.

We have compared, in rabbits, two techniques of limb lengthening by distraction of the epiphyseal plate using a unilateral external fixation frame. In all cases, 14 mm of symmetrical lengthening without deviation was achieved. With rapid distraction at rates of 1 mm per day (distractional epiphyseolysis) separation of the epiphysis from the metaphysis occurred by day 7, and by day 70 almost complete ossification of the cartilage and the elongated segment was evident. In contrast, slow distraction at 0.25 mm every 12 hours (chondrodiatasis) produced hyperplasia of growth cartilage without any evidence of detachment at 28 days, the end of the distraction period. By day 70 the epiphyseal plate had returned to normal thickness with normal cellular morphology, while the lengthened segment was occupied by ossified tissue. The significance of these findings is discussed.

Animals↗
PubMed1988

Primary epiphyseal osteomyelitis in children. Report of three cases and review of the literature.

In the literature 21 children have been reported with haematogenous osteomyelitis involving only the epiphyses of long bones; in 20 the epiphyses of the knee were involved and the radiographs showed a lytic lesion. Most patients gave a history of pain, limp or refusal to walk for weeks or months without general illness. The erythrocyte sedimentation rate and white cell count were of little diagnostic value, but a bone scan was usually positive. All the patients were cured by antibiotics alone or in combination with curettage.

Child, Preschool↗
PubMed1977

Lateral widening of epiphyseal plates in knees of children with bowed legs.

Five children are described in whom genu varum was associated with widening of the lateral segment of epiphyseal growth plates at the knees. The proximal end of one tibia was involved in three cases and the distal end of one femur in two. This finding is thought to represent an epiphyseal diastasis caused by the low grade chronic stress of the bow leg deformity.

Adolescent↗
PubMed1982

Breaking force of the rabbit growth plate and its application to epiphyseal distraction.

The in vitro breaking forces of the distal femoral growth plates of young rabbits were measured as a background to the design of a bone lengthening method, using epiphyseal distraction. The mean breaking force in 16 femora was 12.98 +/- 3.48 kg and the mean strain was 0.91 +/- 0.33 mm. The mean stress in 10 femora was 14.51 +/- 3.88 kg/cm2. The procedure was repeated, after applying a 1.0 kg dead weight to 6 femora for 24 hours and the breaking force was then 15.01 +/- 4.70 kg, with a mean strain of 0.85 +/- 0.62 mm. A further 8 rabbits then underwent epiphyseal distraction for 2 days in vivo, with 1 or 2 kg forces delivered to two parallel K wires by a pair of spring devices, whereupon the femora were removed and tested as before. The breaking force on the distracted side was now only 8.91 +/- 3.71 kg, compared with 13.99 +/- 3.40 kg on the control side. Although not fractured, these plates had obviously been weakened. The clinical implication of this is discussed.

Animals↗
PubMed1982

Inhibition of partial closure of epiphyseal plate in rabbits by indomethacin.

The efficiency of indomethacin (10 mg/kg/day) in inhibiting recurrent partial closure of the epiphyseal plate was tested in rabbits. An epiphysiodesis was done laterally in the distal left femoral epiphyseal plate in 10 adolescent rabbits. This produced a valgus deformity in 14 of them. The bone bridge was then removed operatively and the rabbits were treated with either indomethacin or vehicle for 21 days postoperatively. Indomethacin plasma levels were about 180 ng/ml. The valgus deformity improved in indomethacin-treated rabbits, whereas it became worse in the controls (P = 0.004).

Animals↗
PubMed1976

Variations in the relationship between the diaphysis and the epiphyses of the tibia.

In all 56 tibiae from Lapps and 56 tibiae from Norwegians have been studied. These ethnic groups represent different weight bearing situations. Variables expressing adaptation to non-axial loading are dealt with. The bone is mainly studied in the AP and the ML planes, as well as in the three dimensional space. The material is analyzed statistically. The distribution form is examined and the deviations from normality are found to be moderate. Mainly positive skewness occurs. Platykurtosis is found as often as leptokurtosis. The deviations from a standard normal distribution are not supposed to affect the results significantly. There is a non-systematic pattern of distribution. The variability is generally lower in Lapps than in Norwegians. The standard deviation shows highest numerical values in indices, lowest in linear variables. Systematic group differences, especially in similar variables, are supposed to be of greater importance than isolated differences. The variables giving deviations from the reference planes or the diaphyseal axis, show the largest and the consistent left-right differences. In linear variables Lapps and females show lower mean values than males and Norwegians, respecitvely. In linear variables giving deviations from the reference planes, in angular variables and in indices, Lapps usually show the highest mean values. Lapps tend to show larger sex differences in variables giving deviations from the reference planes or the diaphyseal axis. However, the sex differences within the Lapps are small. The variations of the tibia are supposed to be the results of mechanical factors in bone remodelling. The epiphyseal-metaphyseal parts tend to have a constant shape, the adaptations to non-axial loading predominantly appearing in the diaphysis. The relation between the weight bearing line and the diaphyseal axis is discussed, particularly regarding the ML stability mechanism of the knee joint. The occurrence of torsion and its influence upon the AP and ML projected values regarding the relationship between the epiphyses and the diaphysis are discussed.

Biometry↗
PubMed1978

Tibial fractures involving the ankle in children. The so-called triplane epiphyseal fracture.

Triplane fractures of the distal end of the tibia in fifteen children (average age, thirteen years) represented 6 per cent of 237 consecutive epiphyseal fractures of the ankle. Thirteen children were treated by closed methods (including manipulation) and two had open reduction of the fractures. At an average of twenty-six months after injury, three of fourteen patients showed roentgenographic evidence of premature symmetrical epiphyseal closure with less than 0.5 centimeter of shortening and no angular deformity. Of twelve children examined clinically, three had a 5 to 10-degree external rotation deformity and one patient also had an articular incongruity due to inadequate reduction. In the five cases in which tomograms were used to the medial malleolus, and the anteromedial part of the epiphysis. The lateral fragment included the remainder of the epiphysis together with a piece of posterior metaphysis with attached fibula.

Adolescent↗
PubMed1999

[Ultrasonographic diagnosis of an epiphyseal detachment of the upper end of the humerus due to birth injury].

Injuries to the proximal humerus in infants are often missed or misinterpreted because of the non ossification of the epiphysis. Ultrasound allows direct visualisation of the proximal humeral epiphysis, metaphysis, joint space, and relationship with the glenoid cavity. Ultrasound diagnosis of other epiphyses birth trauma has been reported. Ultrasound should be considered as the first imaging modality if traumatic epiphyseal dislocation is suspected in a newborn.

Birth Injuries↗
PubMed1999

Epiphyseal, vertebral, and ear (EVE) dysplasia: a new syndrome?

We report on the association of epiphyseal, vertebral, and ear dysplasia in two sisters with normal stature and psychomotor development born to distantly related, healthy parents. This distinctive association has not been reported previously and is likely to represent a new condition with an autosomal recessive mode of inheritance. For this syndrome, we propose the acronym EVE standing for epiphyseal, vertebral, and ear dysplasia.

Child↗
PubMed2001

Epiphyseal changes after proximal femoral osteotomy.

This study was conducted to evaluate the risk factors for epiphyseal changes suggestive of osteonecrosis after proximal femoral osteotomy for hip subluxation associated with cerebral palsy. Forty-eight children with 94 hips were reviewed. Two observers rated the radiographs using a written protocol on two occasions each so that reproducibility of these observations could be assured. Concomitant pelvic osteotomy proved to have the greatest association with risk of epiphyseal changes. These findings, suggestive of osteonecrosis, were present in 7 of 68 (10%) hips that had isolated femoral osteotomy, and in 12 of 26 (46%) hips that had concomitant pelvic osteotomy.

Cerebral Palsy↗
PubMed1975

Instrcapsular epiphyseal osteoid osteoma of ankle joint. A case report.

A 12-year-old boy with ankle pain following minor trauma was found after a month of conservative treatment to have a small sclerotic lesion in the anterolateral distal tibial epiphysis. At operation, a vascular, raised, intracapsular epiphyseal lesion was removed. Microscopic examination revealed an osteoid osteoma. To the authors' knowledge no previous example of intracapsular epiphyseal osteoid-osteoma has been reported.

Ankle Joint↗