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Freiberg Kohler Disease KinderRadiologie (Visit this link)
Xray illustration and discussion
Freiberg-Kohler's disease is the only bone necrosis that is more often seen in girls than in boys.
II: partially detached osteochondral lesion
III: completely detached, non-displaced fragment
IV: detached and displaced fragment
There are 4 stages:
1. Initial stage with cartilaginous edema and joint effusion. The X-ray is still unnoticeable, in MRI bone marrow edema.
2. Condensation-density of bone structures in hypermineralization of necrotic bony trabecula. In the X-ray it is already seen, in MRI double-line sign.
3. Fragmentation with deformity of joint structures. Up until this stage, 2 or 3 years since begin of disease may have passed.
4. Repair with replacement of necrotic tissue with the new bone substance. Requirement: Revascularisation
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Added: Wed Jul 11 2007
