Causes Of Claudication In Children
Authors: Pinheiro Ana Costa , Ferreira Filomena , Areias Margarida , Oliveira Carolina , Sousa Cristina , Leal Miguel 
Published: June 2018

Introduction: A claudication in childhood is a common complaint. The differential diagnosis is adjusted to several factors, among the most important to the age of childhood. Osteochondrosis is a term used to describe a group of disorders that affect the growing skeleton. These disorders result from abnormal growth, injury or excessive use of the growing growth plate and surrounding ossification centers. The exact etiology of these disorders is unknown, but genetic causes, repetitive trauma, vascular anomalies, mechanical factors and hormonal imbalances may play a role. Van Neck-Odelberg disease is a disorder causing hip pain and atraumatic lameness. Sever’s illness causes heel pain that is exacerbated by the activity and use of cleats. It often imitates Achilles tendonitis and is treated with activity and modifications of the shoe, heel cups, and calf stretches. Freiberg’s disease, Köhler’s bone disease, and cuneiform bone disease often cause pain in the feet and are disorders of the metatarsal head, navicular bone, and cuneiform bones respectively. X-rays show sclerosis, flattening and bone fragmentation in all diseases. Objectives: Presentation of several clinical cases of osteochondrosis: Van Neck-Odelberg disease and a cuneiform osteocondrosis, 2nd metatarsal (Freiberg), calcaneus (Sever) and 5th metatarsal base (Iselin). Methods: Retrospective descriptive method with reports of clinical cases based on patients’ electronic clinical processes. Results: A Van Neck-Odelberg disease and a cuneiform osteocondrosis are uncommon and poorly remembered causes, however, no differential diagnosis of claudication in childhood has been included. Radiographic representation is characteristic; Despite imaging findings, cases in cases of asymmetry may create a differential difficulty, and may be confused with stress fracture, osteomyelitis or bone tumor. Integration with clinical assessment data is essential to guide treatment and further investigations. Osteochondrosis in the most frequent feet are in navicular (Kohler), (2nd metatarsal (Freiberg), calcaneus (Sever) and the base of the 5th metatarsal (Iselin).) Or cuneiform involvement is rare, with only 18 cases published in the Literature, mostly boys with the mean age of 5. As X-rays are generally pathognomic and sufficient for diagnosis, failure to recognize this entity, and to provide adequate treatment, may lead to the most invasive and potentially invasive examinations and therapeutics. problems. Conclusion: Through these case reports an alert is sought for an onset of osteochondrosis and gives its imagiological presentation. References Resnick D. Osteochondroses. Resnick D. Diagnosis of bone and joint disorders. 4th. Philadelphia, Pa: WB Saunders; 2002. 4: 3686-741. Symposium: the osteochondroses. Clin Orthop Relat Res. 1981 Jul-Aug. (158):1-98. Erdil M, Imren Y, Bilsel K, Erzincanli A, Bülbül M, Tuncay I. Joint debridement and metatarsal remodeling in Freiberg’s infraction. J Am Podiatr Med Assoc. 2013 May-Jun. 103(3):185-90. [Medline]. Duthie RB, Houghton GR. Constitutional aspects of the osteochondroses. Clin Orthop Relat Res. 1981;(158):19-27. Nigrovic PA. Overview of hip pain in childhood. UpToDate Online. http://www.uptodate.com/online/content/topic.do?%20topicKey=gen_pedi/21233 [subscription required]. Accessed October 25, 2010. Katcherian DA. Treatment of Freiberg’s disease. Orthop Clin North Am. 1994;25(1):69-81. Carmont MR, Rees RJ, Blundell CM. Current concepts review: Freiberg’s disease. Foot Ankle Int. 2009;30(2):167-176. Kasser JR. The foot. In: Lovell WW, Winter RB, Morrissy RT, Weinstein SL, eds. Lovell and Winter’s Pediatric Orthopaedics. 6th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2006:1257-1328. Tsirikos AI, Riddle EC, Kruse R. Bilateral Köhler’s disease in identical twins. Clin Orthop Relat Res. 2003;(409):195-198. 28. Borges JL, Guille JT, Bowen JR. Köhler’s bone disease of the tarsal navicular. J Pediatr Orthop. 1995;15(5):596-598.