Juvenile osteochondreal (chondro-epiphysitis) hypothyroidism

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A consecutive group of twenty-seven cases of juvenile osteochondritis is presented. Of the twenty-seven patients two males were classified as Perthes' disease; one male and one female as slipped upper femoral epiphyses, seven males and three females as Osgood Schlatter's disease, 5 males and 1 female as apophysitis, two males as Köhler's disease and three males and two females as epiphysitis of the spine. The age range was from five to fifteen years. All displayed definitely related symptomatology. The Roentgen diagnoses in all were unbiased as they were made by a cross-section of able roentgenologists. Every patient routinely received desiccated thyroid orally in a full, therapeutic dose. In addition, those patients displaying other signs of endocrine dysfunction, such as the late descent of testicles and delay in adolescence, were treated with the pituitary sex-like hormone. An attempt was made to correct obesity when present. All cases were ambulatory. No immobilization was necessary except for Case IX under Osgood Schlatter's disease whose knee was immobilized for only two weeks. No hospitalization was required. The expense was reduced to a minimum. Normal ossification of the epiphyses was hastened as indicated from the subsequent x-ray findings. Clinical cure was affected more rapidly. It is our belief that the pre-accepted orthopedic methods of treatment are fundamentally incorrect and present many disadvantages. The period of immobilization is long. It can lead to restriction of joint function, muscular atrophy and loss of school and play time. The expense of hospitalization and convalescent care may rise to considerable proportions. Open operations requiring even more detailed care have not produced the desired result either etiologically or functionally because the lacking tissue differentiating factor is not supplied. While immobilization can and does relieve pain, there is no stimulation of the true etiological factor involved without thyroid therapy.