Kashin-Beck disease

Last revised by Ammar Haouimi on 27 Jun 2020

Kashin-Beck disease (KBD) is a rare chronic condition, comprising an osteochondropathy with a concurrent necrosis of the joints.

The disease has traditionally been endemic to areas of Tibet, China, North Korea, and Siberian Russia, and is usually diagnosed in pre-teenage children.

The presentation is similar to rheumatoid arthritis. Extraskeletal disease is not seen.

Pathologically, the lack of dietary selenium is important. The lack of selenium affects the functioning of antioxidants such that osteocartilaginous necrosis ensues. Additional implicated factors with good supporting evidence are dietary deficiency of iodine, mycotoxin-secreting fungi, and polluted water sources 6.

In untreated cases, there will be evidence of the destructive deforming pathology in plain radiographs of joints of the shoulder, elbow, hand, hip, knee, and ankle. Signs of the disease apparent on plain radiograph of the hands include:

  • articular surface depressions
  • carpal crowding
  • subchondral bony deformity in the proximal end of phalanges with or without bony sclerosis
  • fragmentation of proximal phalanges
  • bony enlargement of the phalanges

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