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Shlatter's disease


Description:


Shlyatter's disease - a disease at which there is a dystrophic defeat (necrosis) of a head of a tibial bone.


Shlatter etiologies:


The tibial bone is a long tubular bone of a shin which upper part is jointed with a femur and forms a knee joint. If the sinew of a subnodal cup departing from powerful muscles of a front part of a hip puts the regular repeating pulling pressure upon a knee joint, then there is a premature wear of fabrics of a hillock of a tibial bone and Shlyatter's disease develops. Usually the disease affects one leg, but also both extremities can suffer. Development of such morbid condition is promoted by occupations some sports, for example hockey, soccer, basketball, volleyball, heavy and track and field athletics, big tennis, figure skating, aerobics, injury-causing types of fight. Shlyatter's disease develops at children of age of 10-18 years, especially more often at boys as males experience the raised exercise stresses more often. Any bruises and injuries of a knee also increase risk of a disease. Forecast of a disease favorable.

Патогенез болезни Шлаттера

Pathogeny of a disease of Shlatter


Symptoms of a disease of Shlatter:


The main symptoms of a disease of Shlyatter are the pain in the lower part of a knee amplifying when walking, bending a leg and squats; hypostasis of soft tissues in a knee; periodic attacks of the acute cutting pain in a front part of a knee - in the place where the sinew of a patella is attached to a tibial bone.

The disease begins gradually, imperceptibly, patients seldom connect it with a specific injury. The long time the only complaint of the child can be insignificant pain when bending a knee joint or at rise on a ladder. At the same time no signs of an inflammation are observed. Explicit symptoms of a disease can arise after physical overworks the four-head of a muscle (for example, after squats or jumps at a physical education class, after the sports trainings). In this case there is a swelling in a zone of tuberosity of a tibial bone, considerable pain during walking or run. At rest pain abates. At a palpation of a knee puffiness of fabrics and local pain come to light. At the expense of a swelling contours of tuberosity of a tibial bone smooth out. Active bending extension of a shin causes an acute pain.

Some parents consider that Shlyatter's disease can pass independently eventually if the child ceases to experience the raised exercise stresses on a leg. However, as practice shows, it meets very seldom. In most cases "mechanism" of a course of a disease is already started and even the complete elimination of loading cannot stop it any more. Therefore if the child complains of periodically appearing gonalgia or his knee swelled up a little a little, it is necessary to address the doctor-surgeon surely.


Diagnosis:


Shlyatter's disease is diagnosed by means of radio isotope scanning and a radiographic research. Sometimes in addition carry out ultrasonic examination of a knee joint. A X-ray analysis at Shlyatter's disease it is conducted for identification of the available changes on site of an attachment of a sinew of a subnodal cup.

Radio isotope scanning, unlike X-ray, allows to investigate structure of bones. For this purpose to the patient enter special nizkoradiaktivny liquid which soon gets into his bones into a vein. In two days when radioactive material is absorbed by bones in necessary degree, the research (scanning) by means of the small camera similar to a X-ray apparatus which moves along the studied body parts of the patient is conducted. The procedure is absolutely painless.


Treatment of a disease of Shlatter:


At Shlyatter's disease it is necessary to provide the maximum rest of the affected extremity (immobilization is sometimes shown by a plaster cuff) and to eliminate any exercise stresses. To patients with the similar diagnosis appoint mud and paraffin baths, an electrophoresis with Procainum and calcium (calcium is very important for recovery of the damaged sites of a bone), massage of an extremity and physiotherapy exercises. Favorably on health of the patient the sanatorium therapy will be reflected. From medicamentous drugs apply anesthetics and anti-inflammatory drugs.

In especially hard cases (at strong destruction of a head of a tibial bone and severe pains) carry out an operative measure during which fix tuberosity to a tibial bone by means of a special bone transplant.

The forecast of a disease is very favorable, however in some cases after successful treatment residual deformation in the form of the cone under a knee joint remains. Besides, after treatment of people at sharp change of weather can feel nagging pains and an ache in a knee joint.




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