Physical Therapy- Homecare

Apophysitis and Osteochondrosis: Common Causes of Pain in Growing Bones 👧🧒

👉 Apophysitis results from a traction injury to the cartilage and bony attachment of tendons in children. The apophysis is two to five times weaker than the surrounding structures, including the muscle tendon complex, ligaments, and bones. https://pubmed.ncbi.nlm.nih.gov/19672591/

👉 Consequently, a force causing a ligamentous or tendinous tear and degeneration in adults is more likely to cause an epiphyseal plate or apophysis lesion in a growing child. https://pubmed.ncbi.nlm.nih.gov/902208/, https://pubmed.ncbi.nlm.nih.gov/11357449/, https://pubmed.ncbi.nlm.nih.gov/6843972/

👉 Most often it is an overuse injury in growing children, especially those with tight or inflexible muscle tendon units. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588527/, https://pubmed.ncbi.nlm.nih.gov/37002485/

👉 Unlike apophysitis, osteochondrosis is caused by a temporary disruption of the blood supply at the bone-cartilage complex of a particular joint, and not by traction. These diseases are rare, and the etiology of the disruption is unknown. Multiple possible etiologies have been explored, including genetic causes, hormonal imbalances, mechanical factors, repetitive trauma, and vascular abnormalities. Generally, this is a transient disorder that resolves spontaneously but needs close monitoring to ensure resolution. Surgery is rarely needed for osteochondrosis. https://pubmed.ncbi.nlm.nih.gov/21302869/

📷 The following illustration gives a nice overview of apophysitis and osteochondrosis locations
https://pubmed.ncbi.nlm.nih.gov/31083875/