ConditionBones, joints & muscles
Osteochondrosis
Osteochondrosis is a family of conditions affecting growing bones in children and teenagers, in which the bone and cartilage at a growth center or joint surface are disrupted, often by repeated stress or a temporary loss of blood supply. Common examples are Osgood-Schlatter disease (below the knee), Sever's disease (heel) and Legg-Calvé-Perthes disease (hip). Most cause activity-related pain and heal as the child grows, with rest and activity changes. A few, such as Perthes disease and osteochondritis dissecans, need specialist care.
Also called: Osteochondritis, juvenile osteochondrosis, growth plate disorder, apophysitis
At a glance
- What it is
- Disorders of growing bone and cartilage at growth centers or joint surfaces in children and teens.
- Common types
- Osgood-Schlatter (knee), Sever's (heel), Sinding-Larsen-Johansson (kneecap), Perthes (hip), Köhler's (foot), Scheuermann's (spine), osteochondritis dissecans (joints).
- Causes
- Repetitive stress during growth spurts, and interrupted blood supply in some types.
- Symptoms
- Activity-related pain, tenderness, swelling, limp, stiffness.
- Treatment
- Activity changes, ice, stretching, supportive footwear. Bracing or surgery for some hip and joint forms.
When to get help
See a doctor within a day or two
- A child who suddenly cannot bear weight, or has hip or knee pain with fever
- A limp with hip, groin or thigh pain in a child aged 4 to 10, especially lasting more than a few days
- Hip or knee pain in a child aged 10 to 16 with limping or an outward-turned foot (possible slipped capital femoral epiphysis)
- A knee that locks, catches or gives way
Book a routine appointment
- Pain below the kneecap or at the heel in an active child that persists despite rest
- Pain that wakes the child at night or affects school activities
- A rounded upper back or back pain in a teenager
Usually safe to manage at home
- Mild activity-related pain at the bump below the knee or at the heel in an active, growing child, improving with rest and ice
What osteochondrosis means
Growing bones have growth plates (physes) near their ends and apophyses, growth centers where tendons attach. Some joint surfaces also grow from secondary ossification centers. During growth spurts, these areas are vulnerable to:
- traction stress from tight, strong tendons pulling repeatedly (traction apophysitis)
- compression stress at joint surfaces
- interrupted blood supply, causing bone to soften and fragment, then gradually heal and remodel
Common types
| Condition | Location | Typical age | Key features |
|---|---|---|---|
| Osgood-Schlatter disease | Tibial tubercle (bump below the knee) | 10 to 15 | Painful bump, worse with running and jumping |
| Sinding-Larsen-Johansson | Lower edge of kneecap | 10 to 13 | Pain at the bottom of the kneecap |
| Sever's disease (apophysitis) | Back of the heel | 8 to 12 | Heel pain with running, squeezing the heel hurts |
| Legg-Calvé-Perthes disease | Ball of the hip | 4 to 10 | Painless or painful limp, groin, thigh or knee pain |
| Köhler's disease | Navicular bone in the foot | 4 to 7 | Pain in the arch, limp |
| Freiberg's disease | Second metatarsal head | Teen girls | Forefoot pain |
| Panner's disease | Elbow (capitellum) | Under 10 | Elbow pain, throwing sports |
| Scheuermann's disease | Thoracic spine | Teens | Rounded upper back (kyphosis), back pain |
| Osteochondritis dissecans | Knee, ankle, elbow joint surface | Teens | Pain, swelling, catching or locking |
Causes and risk factors
- rapid growth spurts
- high-volume sports, especially running, jumping and kicking (soccer, basketball, gymnastics, dance)
- tight muscles and tendons around growing joints
- repetitive throwing (elbow)
- in Perthes disease: temporary loss of blood supply to the hip ball, more common in boys and small-for-age children
Symptoms
- pain during and after activity that eases with rest
- tenderness and sometimes swelling over the growth center
- a visible bump (Osgood-Schlatter)
- limping
- stiffness or reduced movement, especially hip rotation in Perthes
- catching, locking or giving way in osteochondritis dissecans
Hip problems often cause pain felt in the knee. Any child with knee pain and a limp should have the hip examined.
Diagnosis
- history and examination: location, activities, growth
- X-rays: confirm many types and rule out fractures or tumors
- MRI: for osteochondritis dissecans and early Perthes disease
- blood tests if infection or inflammatory arthritis is possible
Treatment
Traction apophysitis (Osgood-Schlatter, Sever's, Sinding-Larsen-Johansson)
- reduce, not necessarily stop, aggravating activities
- ice after activity
- stretching of the quadriceps, hamstrings and calves
- heel cups for Sever's disease
- knee straps for Osgood-Schlatter
- acetaminophen (paracetamol) or ibuprofen, following the label dose for the child's age and weight
- symptoms settle as growth plates close
Perthes disease
- managed by a pediatric orthopedic specialist
- observation and activity modification for younger children with mild disease
- physical therapy to maintain hip motion
- bracing or surgery (osteotomy) in older children or more severe cases
Osteochondritis dissecans
- stable lesions in young patients: rest from impact sports for 6 to 12 weeks or longer
- unstable or loose fragments: arthroscopic surgery to fix or remove them
Scheuermann's disease
- exercise and physical therapy
- bracing for significant curves in growing teens
- surgery rarely
Outlook
Most traction apophysitis conditions resolve completely once growth finishes, though a bump below the knee may remain. Perthes disease outcomes depend on age at onset and severity, with younger children doing better. Untreated unstable osteochondritis dissecans can lead to early arthritis.
Frequently asked questions
What is osteochondrosis?
Osteochondrosis is a group of conditions affecting growing bones in children and teens, where bone and cartilage at a growth center or joint surface become inflamed, damaged or temporarily lose blood supply. Common examples are Osgood-Schlatter, Sever's and Perthes disease.
What causes osteochondrosis?
Repetitive stress on growth centers during growth spurts, especially in active children, is the main cause of the traction types. Some types, such as Perthes disease, result from a temporary loss of blood supply to the bone.
Is osteochondrosis serious?
Most types, such as Osgood-Schlatter and Sever's disease, are not serious and resolve with growth. Perthes disease and osteochondritis dissecans can affect long-term joint health and need specialist management.
Can my child keep playing sports with osteochondrosis?
Often yes, with modified training. Children with traction apophysitis can usually play within pain limits. Hip conditions and osteochondritis dissecans may need a longer break. A doctor can advise based on the type.
Does osteochondrosis go away?
Traction types usually go away when the growth plates close in the mid to late teens. Perthes disease heals over 2 to 4 years. Osteochondritis dissecans may heal with rest or need surgery.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Orthopaedic Surgeons (OrthoInfo): Osgood-Schlatter disease; Perthes disease; Osteochondritis dissecans
- Pediatric Orthopaedic Society of North America (POSNA): OrthoKids conditions
- American Academy of Pediatrics: Sports medicine resources
- NHS: Perthes' disease
- MedlinePlus: Osteochondrosis