Kaschin-Beck disease (KBD) is an endemic bone disease which occurs in children and takes degeneration and necrosis of articular cartilage, epiphyseal cartilage and epiphyseal cartilage plate as the basic pathological changes. In China, it is mainly distributed in a long and narrow mountain zone from the northeast to Tibet. The reason is still not completely clear. In the epidemic area, the low selenium content in soil, grain and human hair has a very obvious negative correlation with the disease. The total amount of humic acid and humic acid (-OH) in water have obvious positive correlation with diseases. The lack, surplus and imbalance of trace elements in drinking water in Kaschin-Beck disease area may be the factors that cause malnutrition. In addition, the prevention of Kaschin-Beck disease by "eating grain, improving water and paying attention to hygiene" has also achieved good results. The onset age of this disease is young, generally 3- 15 years old children, and the incidence rate of hands, feet and ankles is high.

[Clinical manifestations]

Typical manifestations are dwarfism, enlarged bone end, limited joint movement and pain. The earlier the onset age, the more obvious the joint deformation and dwarfism, and the symptoms of adult patients are generally mild and often confined to the joints.

[Imaging manifestations]

The disease is a systemic, multifocal and chondronecrotic disease, which occurs in the process of bone development and will last for life. X-ray signals are summarized as follows:

1. The metaphyseal edge is fuzzy or uneven, wavy or even serrated. If the lesion continues to develop, the irregular edge of the phalanx may break. At this point, the joint has no obvious deformation.

2. It is characterized by the beginning of epiphysis and diaphysis fusion. The epiphysis began to merge from the central part and gradually expanded to the edge. The epiphysis itself is also damaged, segmented and uneven, or it may be completely absorbed. The metaphyseal end may be a cup-shaped depression with bone marrow embedded in it, which will heal early and stop development.

3. The epiphysis is completely fused, the longitudinal development of bone stops, and the diseased bone becomes shorter and thicker. Because the metaphyseal fusion is different in the morning and evening, the phalanges may be uneven in length, and the bone ends are wide and deformed, which makes the joints thicker.

4. If the epiphyseal end heals, young people will get sick, and the clinical symptoms will be more common and serious. The joint is damaged relative to the bone end, which can affect the whole joint. It is characterized by Kaschin-Beck disease deformity and may be accompanied by short bones.

5. A series of signs of Kaschin-Beck disease are the repair and secondary changes after cartilage necrosis. Only after the repaired tissues, especially the bones, are changed and shaped can the lesions develop into regression, stability or deformity.

[Differential diagnosis]

The occurrence and development of X-ray signs of Kaschin-Beck disease are related to the onset age and location. Therefore, differential diagnosis should be differentiated from diseases such as chondrodysplasia, rheumatoid arthritis, traumatic or degenerative arthritis according to different conditions. Combining epidemiological and clinical manifestations, the diagnosis of this disease is not difficult.

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