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PubMed1986

[Epiphyseal fractures].

The distal humerus and distal tibia are the most common sites of epiphyseal fractures. Epiphyseal detachment was found to occur more often in the region of upper extremities. Treatment of children for epiphyseal fractures is inevitably accompanied by growth disorders. Articular and diaphyseal malpositions are controllable. Fractures in childhood and, consequently, epiphyseal fractures should be grouped by diaphyseal and articular fractures. Epiphyseal detachment should then be associated with diaphyseal fractures, and epiphyseal fractures should be grouped under articular fractures.

Bone Development↗
PubMed1997

Age of epiphyseal closure in tamarins and marmosets.

Estimates of the chronological age for animals of unknown age provide useful information for medical, demographic, and evolutionary studies. Skeletal development, as indicated by epiphyseal closure, can be used to estimate an animal's chronological age or specify its stage of development. Many studies of Primate skeletal development have used animals of unknown age, with the order of epiphyseal closure providing a relative age for each animal. This study examines the age of epiphyseal closure at 22 epiphyseal sites using animals of known age at death in three calitrichid species (Saguinus fuscicollis, Saguinus oedipus, and Callithrix jacchus). The observed average age of epiphyseal closure is similar in these tamarins and marmosets. There is a significant difference in rate of development between the species. Regression equations can predict the age of unknown animals to within 4.8 months for S. fuscicollis, 8.6 months for S. oedipus, and 7.6 months for C. jacchus (twice the standard error of the estimate). These age estimates allow us to determine if an animal is relatively mature or immature, but are largely unacceptable for studies in which precise age estimates are necessary. The order of epiphyseal closure is similar across 11 monkey species (using additional data from published literature) and supports the suggestion of a general pattern in Primate skeletal development.

Age Determination by Skeleton↗
PubMed2000

Accuracy of MR imaging for detecting epiphyseal extension of osteosarcoma.

BACKGROUND: Too few patients are receiving epiphyseal-sparing limb salvage procedures for osteosarcoma. OBJECTIVE: To determine how magnetic resonance (MR) imaging can best predict the epiphyseal extension of osteosarcoma. MATERIALS AND METHODS: Forty children underwent complete pretreatment static and dynamic contrast-enhanced MR imaging (DEMRI). Static MR images [T1-weighted and short tau inversion recovery (STIR)] of the epiphyses were read in three ways: (1) for suspicion of any abnormality (tumor or edema), (2) for suspicion of tumor, excluding suspected edema, and (3) validating the second method by using a scale to rate the likelihood of tumor. Presentation imaging was compared to histopathologic findings after chemotherapy and resection. The receiver operating characteristic (ROC) method was used to analyze the scaled ratings of static MR and DEMRI values. RESULTS: At delayed resection, 20 of 40 children with osteosarcoma had confirmed epiphyseal tumor; however, 32 epiphyses were abnormal on STIR and 28 abnormal on T1. Differentiating suspected tumor from edema increased the accuracy to an Az (area under the ROC curve) of 0.94 for both T1-weighted and STIR static sequences. T1-weighted MR had better specificity and STIR better sensitivity at any given rating. DEMRI was slightly less accurate (Az = 0.90). CONCLUSION: Static MR imaging most accurately detected epiphyseal extension of osteosarcoma when readers distinguished suspected tumor from edematous or normal tissue.

Adolescent↗
PubMed1983

Structural changes during development in bovine fetal epiphyseal cartilage.

Sedimentation coefficients of approximately 150 S show that proteoglycan aggregates from bovine fetal epiphyseal cartilage are exceptionally large. To determine the structural basis for the unusually large size of these proteoglycan aggregates, identify changes in proteoglycan structure with changing developmental age, and provide a basis for demonstrating the structural modifications which may occur in growth plate proteoglycan aggregates during endochondral ossification, we examined the molecular architecture and dimensions of fetal epiphyseal proteoglycans by electron microscopy. The eight bovine epiphyseal cartilages studied ranged in fetal age from 168 to 241 days. Proteoglycans were extracted in 4 M guanidinium hydrochloride containing protease inhibitors and isolated by equilibrium density gradient centrifugation under associative and dissociative conditions. Electron micrographs were made from monolayer preparations of proteoglycan-cytochrome c mixtures on nitrocellulose support films. The overall molecular architecture of the proteoglycan aggregates from fetal epiphyseal cartilages was similar to that of aggregates from other cartilages and showed a single, unbranched central hyaluronic acid filament to which many proteoglycan monomers were attached. However, the dimensions of the fetal proteoglycans differed strikingly from those of proteoglycans from mature cow nasal or immature calf nasal cartilage. Specifically, proteoglycan aggregates from bovine fetal epiphyseal cartilage showed: (a) longer hyaluronic acid central filaments; (b) greater numbers of proteoglycan monomers per aggregate; (c) closer spacing of proteoglycan monomers along the hyaluronic acid central filament; and (d) longer proteoglycan monomer core proteins. Proteoglycan monomers bound to hyaluronate consisted of two segments: (1) a peripheral thick segment, composed of the chondroitin sulfate chains condensed along the peripheral portion of the protein core, which corresponds to the chondroitin sulfate-rich region; and, (2) a central thin segment, devoid of visible glycosaminoglycan chains, which attaches directly to the hyaluronic acid central filament and contains the hyaluronic acid binding region and a portion of the keratan sulfate-rich region. The contribution of the thin segment to total monomer length decreased as total monomer length increased. Thus, in longer monomers the thick segment contributed more to total monomer length and the thin segment contributed less. Both the thin and thick segments of monomers from fetal epiphyseal cartilage were longer than the corresponding segments of calf nasal cartilage and mature bovine nasal cartilage monomers.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1991

Congenital hypothyroidism--correlation between radiographic appearances of the knee epiphyses and biochemical data.

Plain knee radiographs of 20 neonates with congenital hypothyroidism, were reviewed. The size and appearances of the epiphyses were compared with the biochemical data at the time of referral. Fifteen infants had unequivocal evidence of delayed bone maturation based on absence of the distal femoral epiphysis or small epiphyseal size. Seven cases had fragmentation of at least one epiphysis. A positive correlation was found, at diagnosis, between the thyroxine and triiodothyronine levels and the size of the knee epiphyses. All 14 infants with thyroxine levels of less than 70 nmol/l had small epiphyses with a combined mean diameter of the proximal tibial plus distal femoral epiphyses of 7 mm or less. Conversely, of the 6 infants with thyroxine levels of 70 nmol/l or above, 5 had combined epiphyseal diameters of greater than 10 mm. We suggest that in infants with no clinical symptoms and only moderately raised raised screening thyroid stimulating hormone, a knee radiograph showing the described radiological changes should prompt institution of thyroxine treatment before awaiting biochemical confirmation of the diagnosis.

Congenital Hypothyroidism↗
PubMed1978

The effect of dynamic loading on the growth of epiphyseal cartilage in the rat.

The Hueter-Volkmann law of epiphyseal pressures describes an inverse relationship between static compressive forces parallel to the axis of epiphyseal growth and the rate of growth of that cartilage. Studies of histological sections of the epiphyseal plate of the fourth metatarsals of (a) control, (b) bipedal and (c) bipedal rats with amputation of the fifth metatarsal show that dynamic compressive forces can stimulate epiphyseal cartilage growth. Within certain parameters, both the relief and increase of dynamic compression accelerate epiphyseal growth. It is the amount and kind of loading that are important factors to accelerate epiphyseal growth.

Age Factors↗
PubMed1976

The effect of single dose of oestrogens administered during the early postnatal period on the DNA content of rat bone epiphyses.

It has been shown previously that the administration of a single dose or oestrogens to male rats during the early postnatal life retards growth, after a latent period lasting several weeks, [slowing down of body weight and body lenth increments]. We therefore studied the effect of a single subcutaneous dose of oestrogens (1.25 mg oestradiol dipropionate) administered on the 5th postnatal day on the DNA content and DNA concentration in the parts of long bones associated with growth (distal epiphysis of the femur, and proximal and distal epiphyses of the tibia together with the epiphyseal plates). The rats were decapitated at the age of 18, 25 and 40 days, the given parts of the bones were immediately dissected out, weighed and their absolute DNA content and DNA concentration were analyzed. The weight of the distal femoral epiphysis of oestrogen-treated rats was found to be significantly lower at 40 days than in the controls. At the same age, its DNA content and concentration were likewise significantly lower in animals given oestrogens on the 5th day of life. The weight of the proximal tibial epiphysis of oestrogen-treated rats was significantly lower from the 25th day, while its DNA content was already significantly lower on the 18th day and the difference was maintained up to the 40th day of life. A significant decrease in the DNA concentration in oestrogen-treated rats did not appear until the 40th day. The weight of the distal tibial epiphysis of experimental rats was also significantly lower from the 25th postnatal day onwards and its DNA content was significantly lower by the 18th day. At 25 days, the DNA content was slightly lower in oestrogen-treated rats, but the significance of the difference disappeared, although it re-appeared on the 40th day of life. As in the two preceding epiphyses, the DNA concentration in the distal tibial epiphysis was not significantly lower in oestrogen-treated animals before the 40th day of life. The results show that the administration of oestrogens in the early postnatal period significantly affects both the absolute DNA content and the DNA concentration in all the epiphyses in question. The reaction does not appear in all the epiphyses at the same time, however. Differences in the degree of maturity of the epiphyses are evidently responsible for the variability of the response as regards the time at which the above changes occur.

Animals↗
PubMed1986

Vascularized fibular epiphyseal transfer. A clinical study.

In a review of the experimental and clinical literature on nonvascularized and vascularized epiphyseal transfer, experience with eight patients with free vascularized fibular epiphyseal transfer suggests that transfer of bone with an open epiphysis offers some potential for growth in either congenital abnormalities or epiphyseal arrest secondary to trauma and infection. In four cases, premature epiphyseal closure prevented appreciable growth. In the other four, the epiphyses remain open and the transferred bones continue to grow. Although the procedure is experimental, the results of combined epiphyseal and metaphyseal vessel transfer with a skin island as a monitor of viability, warrant further investigation.

Arm↗
PubMed1978

Responses of articular and epiphyseal cartilage zones of developing avian radii to estrone treatment and a 2-G environment.

Female chicks at 2 weeks post-hatch were maintained for 2 weeks at earth gravity or 2 G with daily injections of 0.2 or 0.4 mg estrone. Animals were sacrificed following the last injection and radii were fixed in 10% NBF, decalcified in 3% Nitric acid, doubly embedded, sectioned at 4 to 5 micrometer, and routinely processed for histological measurements of the midcoronal height and width of the cartilage zones of the proximal and distal epiphyses. Estrone treatment increased the growth in height and width of the cartilage layers of the proximal epiphyses and inhibited the growth in height of the distal epiphyseal cartilage of earth gravity chicks. Animal exposure to 2 G without estrone treatment resulted in increased width of the cartilage layers of the proximal epiphyses and inhibition of both height and width growth of the cartilage layers of the distal epiphyses. Growth in height, but not width, of the cartilage layers of both proximal and distal epiphyses was inhibited by combined estrone treatment and animal exposure to the 2 G environment.

Animals↗
PubMed1983

Legg-Calvé-Perthes disease. Histochemical and ultrastructural observations of the epiphyseal cartilage and physis.

UNLABELLED: Biopsy specimens of the lateral aspect of the femoral head and neck were obtained from five children with Legg-Calvé-Perthes disease and were studied using histochemistry and electron microscopy. Beneath the normal articular cartilage there was a thick zone of hyaline (epiphyseal) cartilage containing sharply demarcated areas of hypercellular and fibrillated cartilage with prominent blood vessels. The fibrillated cartilage was strongly positive to alcian blue, weakly positive to periodic acid-Schiff, and positive to aniline blue. The interterritorial matrix in the hypercellular areas was weakly positive to both alcian blue and periodic acid-Schiff. Ultrastructural examination of these areas revealed many irregularly oriented large collagen fibrils and variable amounts of proteoglycan granules. These results suggest that in the fibrillar areas there are: (1) a high proteoglycan content, (2) a decrease in structural glycoproteins, and (3) a different size of collagen fibrils from that of normal epiphyseal cartilage. The hypercellular areas had a decrease in proteoglycans, glycoproteins, and collagen. The lateral physeal margin was often irregular, with a marked reduction of collagen and proteoglycan granules, and contained numerous large lipid inclusions. CLINICAL RELEVANCE: The abnormal areas in the epiphyseal cartilage of patients with Legg-Calvé-Perthes disease have different histochemical and structural properties from normal cartilage and from fibrocartilage. This suggests that the disease could be a localized expression of a generalized, transient disorder of epiphyseal cartilage that is responsible for delayed skeletal maturation. The cartilage lesions are similar to those seen in the vertebral plates in patients with juvenile kyphosis. Whether the epiphyseal cartilage abnormalities are primary or are secondary to ischemia remains uncertain; however, it appears that the collapse and necrosis of the femoral head could result from the breakdown and disorganization of the matrix of the epiphyseal cartilage, followed by abnormal ossification.

Cartilage, Articular↗
PubMed1997

[Special epiphyseal injuries. 5 case examples].

In daily practice, the well-proved Salter-Harris-Rang epiphyseal injuries classification is used worldwide and in Hungary as well. Occasionally there are to be seen epiphyseal injuries which cannot be typed by this classification. The Ogden classification of epiphyseal injuries which enlarges the Salter-Harris-Rang classification with 6 subdivisions and 3 more subdivisions is very useful for the classification of such rare epiphyseal injuries. The authors focus one's attention on Ogden IIB type and Ogden VI type injuries on the basis of their own experience. Ogden IIB is often unstable and susceptible to shortening. In Ogden VI type ligamentous instability beside growing disturbance, caused by meta-epiphyseal bone bridge formation, can be seen. The comminuted growing plate injury caused by high energy direct trauma and healed without growing disturbance in their case, is missed in the Ogden classification. The proper classification is a necessary condition of adequate treatment. We recommend the Ogden classification of rare epiphyseal injuries.

Adolescent↗
PubMed1994

[Reaction of the epiphyseal groove to groove-crossing bore-wire osteosynthesis. Results of a histomorphologic small animal study].

In young rabbits of five to six weeks of age we revealed bony bridging as constant reaction of the epiphyseal cartilage on drilling with a 2 mm diameter trephine into the distal femur growth plate. Gross growth disturbances will be the consequence of such partial closures. For this present study we inserted one 2 mm Kirschner-wire across the epiphyseal plate of the distal femur. The drilling was directed distally. During longitudinal growth the epiphysis moves away from the wire, that remains 8 weeks after the operation completely within the metaphyseal cancellous bone. Four, 8, 12 and 16 weeks postoperatively one group of the rabbits were sacrificed. After radiological examination of the explanted femurs fixation and embedding in methylmetacrylate for morphological examination was performed. Our histological results reveal, that the crossing Kirschner-wire does not irritate the growth plate, even the physiological structure of the epiphyseal cartilage in the direct contact to the metal implant is not altered. The defect within the epiphyseal plate left after the relative retraction of the wire caused by growth activity fills with cancellous bone. Its trabecular structure is markedly thinner than the spongy bone within the metaphysis and shows longitudinal orientation. These trabeculae undergo segmental disruption by the growth pressure of the surrounding epiphyseal plate. In consequence there is no bone bridging and growth alterations by the Kirschner-wire crossing of the epiphyseal plate. This proves experimentally the clinical experienced therapeutic value of Kirschner-wires for internal fixation of dislocated joint injuries.

Animals↗
PubMedDate not supplied

[Epiphyseal dysplasia--symptoms and differential diagnostic aspects].

AIM: Children complaining of hip pain most likely suffer from Perthes' disease. Similar morphological changes are seen in the hereditary diseases of the epiphyseal dysplasias which have a prevalence of about 40 of 100 000 inhabitants. We now show the differentiation between bilateral Perthes' disease, epiphyseal dysplasia and skeletal disorders like mucopolysaccharidosis and pseudoachondroplasia. METHOD: We describe the diseases of multiple epiphyseal dysplasia and spondyloepiphyseal dysplasia on the basis of two case reports. Furthermore, we discuss differential diagnostic aspects, therapeutic options and prognosis. RESULTS: Epiphyseal dysplasias are classified as osteochondral dysplasia. The characteristic feature of these heredopathies is short statue due to skeletal dysplasias at various sites. Multiple epiphyseal dysplasia is caused by an abnormality of enchondral ossification. A distinction is made between the severe Fairbank form, the milder Ribbing form and a mild but rather localised Meyer form. In addition to the femoral head, the spinal bodies can also be affected by the same enchondral ossification disorders and this is defined as spondyloepiphyseal dysplasia. CONCLUSION: The diagnosis of a Perthes' disease can be made from an X-ray of the hip, showing either an advanced necrosis of the femoral head or early signs of it. Typical radiological findings allow the differentiation to other skeletal dysplasias like epiphyseal dysplasia and metabolic disorders.

Adolescent↗
PubMed2003

The zonal distributions of alkaline phosphatase, adenosine triphosphatase, laminin, fibronectin and chondroitin 4-sulphate in growing rat humerus proximal epiphyseal cartilage: a histochemical and an immunohistochemical study.

Although there are many studies about epiphyseal cartilage extracellular matrix (ECM) macromolecules in bone formation, studies of their distribution and role in the mineralization of these components in growing rat humerus proximal epiphyseal cartilage have not been sufficiently detailed. The aim of this study was to determine the distributions of alkaline phosphatase (ALP), adenosine triphosphatase (ATPase), laminin, fibronectin and chondroitin 4-sulphate in growing rat humerus proximal epiphyseal cartilage. The rats were killed by cervical dislocation, and the humeri were removed, sectioned (6 and 10 microm) on a cryotome or paraffin microtome, and stained using histochemical and immunohistochemical methods. ALP and ATPase were markedly observed in the hypertrophy and calcifying cartilage. In addition, ATPase was found to be very strongly positive in the tangential zone of articular cartilage. Results of immunohistochemical staining for laminin, fibronectin and chondroitin 4-sulphate showed that the immunostaining was the heaviest in the tangential zone of articular cartilage. In growing epiphyseal plates, there were differences in the density of these macromolecules of chondrocytes as a function of the maturation process. In conclusion, these ECM macromolecules of epiphyseal cartilage may regulate the cell-cell and cell-matrix interactions as well as the matrix calcification during the ossification of epiphyseal cartilage.

Adenosine Triphosphatases↗
PubMed2000

Histological disorders related to the focal disappearance of the epiphyseal growth plate in rats induced by high dose of vitamin A.

The histological disorders related to the focal disappearance of the epiphyseal growth plate were examined histochemically in the proximal tibia of rats administered a high dose of vitamin A. Animals were given 100,000 IU/100 g body weight/day of vitamin A for 5 days from 4 weeks after birth (VA rats) or given deionized water as control and sacrificed on Day 12 and 19 of the experiment. Tibiae were examined by immunohistochemistry for type I, II and X collagens, lectin-histochemistry for Helix pomatia and backscattered electron imaging. On Day 12, the abnormally developed calcified cartilage matrix was detected within the epiphyseal growth plate in VA rats. The uncalcified cartilage matrix contained type I collagen but lacked type II collagen. In addition, the eroded regions accompanied with numerous osteoclasts and osteoblasts were detected in the epiphyseal growth plate. On day 19, eroded regions penetrated the epiphyseal growth plate to result in its focal disappearances with the eroded surfaces entirely covered with bone tissue in VA rats. These findings suggested that the cartilage matrix of the epiphyseal growth plate was abnormally calcified and showed the phenotypes like bone matrix. The eroded regions of the epiphyseal growth plate seemed to be caused by the invasion of osteoclasts into the altered cartilage matrix and might develop to the focal disappearances by the modeling or remodeling due to action of osteoclasts and osteoblasts.

Animals↗
PubMed1991

[The effects of electrical stimulation on epiphyseal cartilage].

The effects of electrical stimulation on epiphyseal growth were studied. The epiphyseal cartilage of the proximal tibia of New Zealand white rabbits was stimulated by direct current for 2 weeks. A constant direct current of 5 microA was supplied by an electrical stimulation system buried under the subcutaneous tissue. Contralateral tibia with dummy electrodes served as control. The results were as follows: The height of the epiphyseal plate near the electrodes was slightly increased by traumatic reaction to the electrodes in the control group. However, in the stimulation group, the height was more remarkably increased than in the control group. The height of the epiphyseal plate was 0.6 +/- 0.2 mm in the control group, and 1.0 +/- 0.4 mm in the stimulation group, showing a statistical difference. The mineral appositional rate, determined by tetracycline labels, was 3.0 +/- 0.8 microns/day in the control group and 4.6 +/- 0.4 microns/day in the stimulation group. It was observed that the turnover of the epiphyseal plate was accelerated in the stimulation group, but no other abnormal findings were observed by electron microscopy. In conclusion, it is clear that growth of the epiphyseal cartilage is accelerated by direct current.

Animals↗
PubMed1993

Exclusion of type II and type VI procollagen gene mutations in a five-generation family with multiple epiphyseal dysplasia.

We have studied a family with an autosomal dominant form of multiple epiphyseal dysplasia (MED) inherited through at least 5 generations. Bilateral deformity of the hips with subsequent degenerative arthritis was the most common and most severe change observed in the affected relatives. Abnormalities of the knees, ankles, and shoulders were also noted in some affected individuals. Radiological examination showed changes in affected joints consistent with epiphyseal dysplasia. In early stages, the articular surfaces appeared flattened or irregular in shape. In advanced stages, epiphyseal fragmentation, joint surface erosion, and extensive remodeling were observed. The abnormalities of the epiphyses suggested that the primary defect might be in a structural component of the epiphyseal cartilage matrix. The gene encoding type II collagen (COL2A1) was tested for genetic linkage to MED in this family by restriction fragment length polymorphism (RFLP) analysis. Recombination between COL2A1 and MED was observed, ruling out COL2A1 as the site of the mutation. The genes encoding the 3 chains of type VI collagen were also excluded on the basis of discordant inheritance. The disease in this family is therefore not the result of mutations in the genes encoding type II or type VI collagen.

Adult↗
PubMed1985

Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and females.

Epiphyseal union of the anterior iliac crest and the medial clavicle is examined in 605 males and 254 females in a sample of modern Americans aged 11-40 years. The sample includes American whites, American blacks, Latin-Americans, and Orientals. This is the first skeletal investigation using a large sample of individuals of known age since the McKern and Stewart study of 1957. Epiphyseal union is analyzed in terms of four stages: 1) nonunion with no epiphyses, 2) nonunion with separate epiphyses, 3) partial union, and 4) complete union. The results provide broader age ranges for the stages of union than previous studies. Age ranges for males and females are similar or vary by only 1-2 years. Racially, no major distinguishing patterns are found except for greater variability in age distributions appearing to exist among American black females. The study furnishes valuable data on epiphyseal timing in the teenage years.

Adolescent↗