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Tibial physeal changes in renal osteodystrophy: lateral Blount's disease
W L Oppenheim1, S Shayestehfar, I B Salusky
1Department of Orthopedic Surgery, UCLA Medical Center 90024.
Journal of Pediatric Orthopedics
|November 1, 1992
Summary
Children with chronic renal failure and renal osteodystrophy can develop tibial bone changes mimicking Blount's disease. These changes appear related to uneven weight-bearing on the lateral physis (growth plate).
Area of Science:
- Pediatric Orthopedics
- Nephrology
- Skeletal Dysplasias
Background:
- Chronic renal failure (CRF) in children can lead to renal osteodystrophy, affecting bone development.
- Renal osteodystrophy may manifest with skeletal deformities, including physeal abnormalities.
Purpose of the Study:
- To describe unique radiographic changes in the proximal tibial physis of children with CRF and renal osteodystrophy.
- To investigate the potential etiology of these observed physeal changes.
Main Methods:
- Radiographic analysis of 27 children with CRF and renal osteodystrophy.
- Identification and characterization of physeal abnormalities in the proximal tibia.
Main Results:
- Eight patients (15 knees) showed significant involvement of the proximal tibial physis.
- Radiographic changes resembled tibia vara (Blount's disease) but affected the lateral physis.
Conclusions:
- The observed physeal changes in renal osteodystrophy are analogous to tibia vara but involve the lateral aspect.
- Eccentric weight-bearing is proposed as the primary mechanism, distinct from trauma, infection, or genetic factors.