Knee varus knee valgus or coxa varus

Introduction Kaschin-Beck disease is an endemic disease that is prevalent in northern China. The disease was first discovered in the northeast and later found in the northwest. In the northwest region, it is also known as willow disease. Most of the epidemics are concentrated in one area and become an infected area. The cause of this disease is inconsistent in the fusion rate of the tarsal plate, and the lower extremities often have knee varus, knee valgus or hip varus deformity. The cause of Kashin-Beck disease is still unknown, and most people believe that it may be related to pathogenic mold in the grain. Kaschin-Beck disease cannot be cured, nor can it inhibit the development of lesions. Symptomatic treatment can reduce pain. Patients with obvious joint deformities can be treated with surgery.

Cause

The cause of Kashin-Beck disease is still unknown. It was suspected to be caused by chronic poisoning of the mouth, but it was not confirmed. Most people think it may be related to pathogenic mold in the grain. Animal experiments have found that the pathological changes in the bones of animals fed with cereals with pathogenic molds are very similar to those of large joint diseases. The pathogenic mold may be Fusarium, but it has not been fully confirmed.

an examination

Related inspection

CT examination of bone and joint and soft tissue

If it occurs in adolescence, due to the early ossification of the epiphyseal plate, the developmental disorder appears as a dwarf type. The patient has a short stature, large joints, and limited pain and mobility. The ankle is the earliest, followed by the finger joints, knees, elbows, wrists, toe joints, and hips. Because of the inconsistent speed of the tarsal plate, the lower extremities often have knee varus, knee valgus or hip varus deformity. The fingers are short and small, and the feet are flat. The younger the age, the heavier the deformity.

If it occurs in the later stages of adolescence, the deformity is not obvious. Mainly manifested as symptoms of osteoarthritis, joint swelling, a small amount of fluid, a sense of friction during exercise, and sometimes with interlocking symptoms, and sometimes can be detected in the joints with free body. There are many cases of lower extremity in adults, and it is very inconvenient to walk because of swelling of the knees and knees.

X-ray films are very similar to osteoarthritis, with ankle joint lesions being the most serious. In the early stage, the joint space is widened, severely irregular, and there are free bodies in the joint. Then the cortical bone density of the articular surface increases and the gap tends to be narrow. Significant bones and lips appear at the edges of the joints. There are often subchondral cystic changes. Often the talus is squashed, the bones are dense, and the shape is flat, just like ischemic necrosis. Thereafter, both the scapular and subtalar joints can develop bone and lip, increase in bone density, and cyst formation under the cartilage. The patellofemoral joints of the knee joint can also be uneven, the edges are many bone lips, the joint ends are thick, and there are free bodies in the joints. After a long time, the joint collapsed. There is a similar change in the hip joint. The femoral head is avascular necrosis and may have a hip varus deformity. In the fingers, the joints are thick, the joint surface is uneven, the joint space is narrow, the bone density is increased, and the phalanx is short.

Differential diagnosis

Knee varus, commonly known as "O-legs", "Road legs", "Bow legs", " basket legs". It means that at the knee joint, the tibia of the calf is rotated inward by an angle, so it is called "knee varus". The definition of knee varus is easily confused by the fact that the shape of the lesion is taken for granted: the definition of knee varus is not named after the angling angle, but is named after the direction of the calf tibia. Knee varus, the knee joint angle is pointing to the outside, so it is often mistaken for knee valgus.

Congenital hip varus: also known as developmental hip varus, a deformity caused by progressive reduction of the femoral neck dry angle in young children. Normal adult neck angle is 120 ° ~ 140 °, children 135 ° ~ 145 °. If the neck dry angle is less than 120°, it is called hip varus. It is one of the common reasons for children to behave in a day. There was more unilateral incidence than bilateral, and there was no significant difference in gender and ethnicity.

Foot eversion: Children's foot valgus, also called valgus and extension, is one of the common deformities of the foot. Contrary to the shape of the inverted foot, it can only land on the inside of the foot and load, and the medial arch often sinks.

Foot varus: During development, due to the failure of the tendon and ligaments (posterior and deep) of the foot, it is not synchronized with the development of other tendon ligaments in the foot. The consequence is that these tendons and ligaments will be sufficient. The posterior medial side is pulled down, causing the foot to twist inwardly and inward. The bones of the foot are therefore in an abnormal position. The foot is varused, stiff, and cannot return to its normal position.

Congenital toe valgus foot: is a common posture foot deformity characterized by full back extension and valgus. More women than men, the ratio is about 1:0.6. After the child is born, the foot extension and valgus deformity can be found. In severe cases, the back of the foot can be in contact with the skin in front of the tibia. At the same time, due to the increased tension of the dorsal and lateral soft tissues, the plantar flexion and varus activity are limited.

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