Neuropathic osteonecrosis of the lateral femoral condyle in childhood. A report on four cases

Citron, ND; Paterson, F.W.N.; Jackson, AM

doi:10.1302/0301-620x.68b1.3510217

Cited by 7 publications

(5 citation statements)

References 2 publications

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“…However, there are also a few reports of HR-NBL patients with osteonecrosis. [32][33][34] Both our HR-NBL survivors with osteonecrosis had received TBI, and the other had undergone kidney transplantation, that probably played the main role in the pathogenesis of osteonecrosis in that patient.…”

Section: Factormentioning

confidence: 99%

Skeletal outcome in long-term survivors of childhood high-risk neuroblastoma treated with high-dose therapy and autologous stem cell rescue

Utriainen

Vatanen

Toiviainen-Salo

et al. 2017

Bone Marrow Transplant

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High-dose therapy and hematopoietic stem cell transplantation (HSCT) have been shown to improve survival rates in high-risk neuroblastoma (HR-NBL), but may cause adverse effects on the growing skeleton. We studied skeletal health in a national cohort of long-term survivors of HR-NBL (n=21; age 16-30 years, median 22 years) and in 20 healthy age- and sex-matched controls. In addition to clinical evaluation and measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry, we performed spinal magnetic resonance imaging. Skeletal complications were categorized according to Common Terminology Criteria for Adverse Events (CTCAE). Altogether, 18/21 survivors presented with at least one skeletal adverse event according to CTCAE, the most common skeletal complications being short stature (n=14) and osteopenia (n=13). Altogether, 38% of the subjects had a severe complication (CTCAE score ⩾3) including bilateral slipped capital femoral epiphyseolysis in 3/21. Fracture rate was not increased. In spinal MRI, no vertebral fractures were found and degenerative intervertebral disc changes were equally prevalent in survivors and controls. BMD was lower in survivors than controls, but differences became non-significant when adjusted for bone size. In conclusion, skeletal late complications are common and can significantly impair the quality of life in young adult survivors of HR-NBL treated with high-dose protocols and HSCT.

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Section: Factormentioning

confidence: 99%

Skeletal outcome in long-term survivors of childhood high-risk neuroblastoma treated with high-dose therapy and autologous stem cell rescue

Utriainen

Vatanen

Toiviainen-Salo

et al. 2017

Bone Marrow Transplant

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“…As observed by Citron et al (1986), treatment in a long leg caliper does not prevent progression of the lesion, and healing takes place at a slow rate producing changes of ossification. In our cases the function of the knee joint became acceptable.…”

Section: Discussionmentioning

confidence: 90%

“…According to Lotke et al (1977), microtraumas create fractures and collapse of subchondral bone leading to leakage of articular fluid into the marrow space with bone necrosis as a result. Citron et al (1986) stressed the anatomic arrangement of the separate condylar arteries with only a few anastomoses. Grclnlund et al (1984) found hypoxia of the subchondral bone as a result of an acute increase in the intraarticular pressure in the rabbit knee.…”

Section: Discussionmentioning

confidence: 99%

“…Further, these patients are prone to some degree of osteoporosis due to vascular changes and diminished activity. Citron et al (1986) called the condition neuropathic in order to separate it from spontaneous osteonecrosis. Even if the latter lesion is mainly located in the weight-bearing area of the medial femoral condyle, other locations have been seen, including the medial tibia1 plateau (Ahlback et al 1968, Rozing et al 1980, Marmor 1982.…”

Section: Discussionmentioning

confidence: 99%

“…Four cases of neuropathic osteonecrosis of the lateral femoral condyle in childhood were reported recently (Citron et al 1986). We have treated epiphyseal osteonecrosis of the knee in two myelomeningocele patients.…”

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confidence: 99%

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Neuropathic osteonecrosis of the knee in childhood: Two cases of myelomeningocele

Kjaerulff

Hejgaard²

1987

Acta Orthopaedica Scandinavica

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Bone marrow magnetic resonance studies in childhood leukemia. Evaluation of osteonecrosis

Pieters

Brenk

Veerman

et al. 1987

Cancer

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In 25 patients under treatment or during follow-up for acute lymphoblastic leukemia magnetic resonance imaging (MRI) of both knees was compared to history and physical examination to detect osteonecrosis. Results of MRI were classified as: 0, normal bone marrow (BM); 1, diffuse decrease in signal intensity; 2, circumscript lesions. Patients clinically suspected of osteonecrosis had a statistically significant increased incidence of Type 2 lesions. Three patients with a BM relapse also showed Type 2 lesions. Circumscript lesions of the epiphyses were seen exclusively in the four patients with clinical suspicion of osteonecrosis during B M remission and this may be a MR finding strongly indicative of osteonecrosis. Patients with Type 2 lesions during BM remission had received systemic chemotherapy for a statistically significant longer period than the other patients. Using MRI findings we suspect that at least four patients suffered osteonecrosis due to chemotherapy. MRI is a promising means of detecting this disorder.Cancer 60:2994-3000. 1987.HILDREN with acute lymphoblastic leukemia C (ALL) treated with combined chemotherapy sometimes complain of bone or joint pain. This may be due to osteonecrosis. In the literature this is often referred to as avascular necrosis of bone. Many case reports of this complication in patients with leukemia have been published.'-I6 However, the frequency of osteonecrosis in children with ALL is unknown. The reported percentages vary from 3% to 85% depending on the population studied and the time and method of diagnosis. 17-20

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Neuropathic osteonecrosis of the lateral femoral condyle in childhood. A report on four cases

Cited by 7 publications

References 2 publications

Skeletal outcome in long-term survivors of childhood high-risk neuroblastoma treated with high-dose therapy and autologous stem cell rescue

Skeletal outcome in long-term survivors of childhood high-risk neuroblastoma treated with high-dose therapy and autologous stem cell rescue

Neuropathic osteonecrosis of the knee in childhood: Two cases of myelomeningocele

Bone marrow magnetic resonance studies in childhood leukemia. Evaluation of osteonecrosis

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