Pages: 1 2
* Originally described simultaneously by Osgood and Schlatter in 1903
* Lesion affects adolescent apophysis of proximal tibia (particularly in young athletes)
* More commonly affects boys than girls (3:1)
* Boys are older at presentation (correlates with ossification dates)
* Bilateral 25-50%
* Controversy regarding etiology, natural history, and treatment.
* Etiology thought to be traction apophysitis secondary to repetitive microtrauma with partial avulsion, inflammation and new bone formation at the ligament insertion.
* Must differentiate from malignancy, infection, fracture, tendonitis and Sindling-Larsen- Johansson Disease.
* Should be referred to a "condition" not a "disease."
* Affects children between 10 and 14 years old, more commonly males 3:1, and is present bilaterally in 25 - 50% of cases.
* Diagnosis is based on clinical signs and symptoms. These include pain, heat, tenderness and local swelling with prominence at the tibial tuberosity.
* Ossification of the tibial tubercle begins distally between 7-9 years of age and progresses proximally.
Infantile cortical hyperostosis
D Suri, D Dayal and M Singh
Advanced Pediatrics Center, -160012, India;
Keywords: Caffeys disease
A 14 week old male infant presented with multiple tender bony swellings involving the legs, forearm, and lower jaw since 1 month of age (fig 1). No history of fever, trauma, or child abuse was forthcoming. He was irritable and had difficulty in feeding since the appearance of the jaw swelling. Bowing of the lower limbs with pseudoparalysis was observed. There was no response to adequate vitamin C supplements received prior to hospitalisation. Investigations showed mild increase of ESR, normal blood biochemistry, sterile cultures, and negative parental serology for syphilis. Bone radiographs revealed periosteal elevation, new bone formation, and cortical thickening involving the diaphyses of bilateral tibia, ulna, and femur (fig 2). The characteristic triad of irritability, swelling, and bone lesions, age at presentation, and mandibular involvement clinched the diagnosis.
Archives of Disease in Childhood 2005;90:711
Indian Pediatrics 2005; 42:64-66
Infantile cortical hyperostosis (Caffey disease) is characterized by radiological evidence of cortical hyperostosis, soft tissue swellings, fever and irritability. We report a case of Caffey disease highlighting its presentation as pyrexia of unknown origin, appearance on radionuclide bone scintigraphy and our unsatisfactory experience of treating it with Ibuprofen, a prostaglandin inhibitor.
Pages: 1 2