KashinBeck

Kashin-Beck disease (KBD) is a chronic, deforming osteochondropathy that predominantly affects children in rural regions. It most commonly targets weight-bearing joints such as the knees, ankles, and wrists and can lead to progressive joint deformities, reduced range of motion, and impaired growth.

KBD is endemic in parts of China—including Shaanxi, Shanxi, Sichuan, Gansu, Tibet, and Xinjiang—and in some areas of Central Asia. The distribution often overlaps with communities that have limited access to selenium-rich foods and exposure to toxins in stored cereals. The exact cause is multifactorial and not fully defined, but the leading factors include selenium deficiency, ingestion of mycotoxins (from Fusarium-contaminated cereals), and inadequate protein and caloric intake. Iodine deficiency and genetic susceptibility may also contribute. The disease is believed to involve disruption of endochondral ossification at the growth plate, with cartilage degeneration followed by subchondral bone changes that culminate in joint deformities.

Clinical features typically begin in childhood with joint pain, stiffness, and swelling, followed by progressive deformities and restricted movement, most often in the knees and ankles. Growth retardation may be observed.

Diagnosis is based on regional epidemiology, clinical presentation, and radiographic findings showing irregularities of the physes, epiphyseal and metaphyseal changes, and early degenerative alterations. Laboratory tests are nonspecific.

Management is supportive and multidisciplinary. It includes analgesia and physical therapy for symptom relief, nutritional optimization, and selenium supplementation in endemic areas. Severe deformities may require surgical intervention such as osteotomy or joint reconstruction. Prevention focuses on improving nutrition, ensuring adequate selenium intake, and reducing exposure to cereal mycotoxins in affected regions. Prognosis varies, with better outcomes where early recognition and preventive measures are implemented.