Remarks on the etiopathogenesis and diagnosis in Osgood-Schlatter and Sever-Haglund diseases based on the Doppler ultrasound of apophyses

Abstract

Assuming the mechanical significance of injuries in the etiopathogenesis of Osgood-Schlatter and Sever-Haglund diseases, it should be recognized that the areas susceptible to damage in growing apophyses are the growth zones and the newly formed bone. The SMI Doppler ultrasound (visualization of microvascular flows) helps to determine the precise location of the lesion, i.e. the area of the greater vascular microflow within the involved apophyses. The ultrasound examination revealed increased microflows within the growth zones of painful apophyses. On the “healthy” side, no microflows were observed. Relief of pain in the tibial tuberosities and the heel correlated with a marked reduction in the vasculature of the previously painful outgrowths. The authors suggest that as regards the imaging studies in Osgood-Schlatter and Sever-Haglund diseases, in the future, the most crucial method may be with Doppler ultrasound with microvascular visualization.