RT Book, Section A1 Wells, Robert G. SR Print(0) ID 1148953504 T1 Hematological and Ischemic Bone Disease T2 Diagnostic Imaging of Infants and Children YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071808392 LK accesspediatrics.mhmedical.com/content.aspx?aid=1148953504 RD 2024/03/29 AB The pathophysiological consequence of bone ischemia is avascular necrosis (osteonecrosis) or bone infarction. Interruption of the blood supply to the bone can result from acute thrombosis, trauma, an underlying vascular disease, or a predisposing osseous disorder. A process that leads to elevation of the intramedullary pressure (e.g., pyogenic infection) can impede perfusion to the point that ischemic necrosis occurs. In addition to infection, conditions that are commonly associated with ischemic bone disease in children include sickle cell disease, steroid therapy, trauma, hemophilia, irradiation, collagen vascular disease, Gaucher disease, and Cushing syndrome. Various sites in the pediatric skeleton can also be involved with idiopathic ischemic necrosis; the most common of these is the hip, that is, Legg-Calvé-Perthes disease. Ischemia in the developing epiphysis of a child can result in growth disturbance due to chondrocyte injury or death in the germinal zone of the primary physis and in the physis of the secondary ossification center. The term ischemic necrosis generally refers to involvement of an epiphysis or subarticular area, whereas bone infarct indicates the consequence of ischemia in the metaphysis or diaphysis.