Kashin-Beck disease: Radiographic appearance in the hands and wrists

PURPOSE: To review the radiographic changes of Kashin-Beck disease (KBD) in the hands and wrists and provide a method for the diagnosis, staging, and evaluation of the effectiveness of prevention and treatment of this disease. To perform radiographic-histologic correlation to facilitate an early diagnosis of KBD. MATERIALS AND METHODS: Hand and wrist radiographs in 300 children and five autopsy cases with KBD from an endemic area of China were analyzed for radiographic changes in the epiphyseal plates, bone ends, epiphyses, and carpal bones. Histopathologic sections of the hand and wrist from five autopsies were studied for comparison with corresponding radiographs. RESULTS: The chief histopathologic changes in KBD included chondronecrosis, secondary repair, and remodeling processes. These histopathologic stages occurred in isolation or simultaneously in a patient. The radiographic and histopathologic changes within cartilage were related specifically to the different sites of cartilage. CONCLUSION: Radiographic changes in the hands and wrists in patients with KBD result from atrophy and necrosis of chondrocytes and their subsequent repair processes in the deep layer of growing cartilage.