Dysplasia Epiphysealis Hemimelica (Trevor Disease) of the Ankle

Nowicki, Philip D.; Borders, Heather

doi:10.3928/01477447-20150402-01

Cited by 7 publications

(24 citation statements)

References 6 publications

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“…Radiographic findings are usually characteristic and present as an irregular lesion arising from the medial or lateral aspect of the affected epiphysis in the early stages. The calcification center will appear earlier and will eventually undergo multicenter ossification [4,7,9,10]. Although rarely reported, there may be several loose bodies around one side of the epiphysis near the lesion, which we consider to be a characteristic performance in the late stage of the disorder.…”

Section: Discussionmentioning

confidence: 83%

“…The etiology of DEH is still uncertain, and there is no evidence to suggest hereditary transmission [5,[7][8][9]. Malignant transformation has not yet been reported [4,5,[9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Although the incidence has been reported as 1 in 1,000, 000, an increasing number of reports show that the incidence is much higher than that [5,8,9]. The age at onset is usually between 2 and 14 years [2,7,10]. DEH has been reported in adults, but such cases are extremely rare.…”

Section: Discussionmentioning

confidence: 99%

“…The formation of a painless, firm bone mass or swelling in the medial or lateral aspect of the affected joint is the most common presenting symptom [2,8,10]. Other symptoms include decreased range of motion, atrophy of the muscles that move the affected joints, and dysfunction of the severely involved joints [6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the symptom severity, the extent of the restricted motion and the location of the lesion, the choice of treatment ranges from simple observation to reconstructive surgery of the affected joint [5,7]. Conservative treatment is recommended for patients without pain or deformity [5,7,10]. Even in cases with mild pain and mild limitations of motion, early and active surgery with complete resection of the lesion is widely accepted because the dysplasia is likely to progress and cause severe osteoarthritis and joint deformities [5,10].…”

Section: Discussionmentioning

confidence: 99%

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TKA in the treatment of bilateral dysplasia epiphysealis hemimelica (Trevor’s Disease) of the knee in a 50-year-old man: a case report

Gao

Guo

Wang

et al. 2020

BMC Musculoskelet Disord

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Background: Dysplasia epiphysealis hemimelica (DEH), also known as Trevor's disease, is a rare skeletal developmental disorder affecting the epiphyses in pediatric patients. DEH is characterized by an asymmetric osteochondral overgrowth arising from either the medial or lateral portion of an epiphysis and usually occurs in the joints of lower limbs, most commonly in the knees and ankles. However, bilateral involvement in an adult is extremely rare, and total knee arthroplasty (TKA) for a patient with DEH has been reported only once before. Case presentation: Here, we present a case of bilateral DEH of the knees that caused varus deformity and dysfunction of the lower limbs in a 50-year-old man. TKA was performed for treatment, and the patient had satisfactory function with no angular knee deformity and a normal range of motion after 1 year of follow-up. Conclusions: The patient in this case exhibited its specific clinical and radiological features of late-term DEH and TKA was proved to be an appropriate procedure for treating the severe deformity caused by this rare disease.

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Section: Discussionmentioning

confidence: 83%

“…The etiology of DEH is still uncertain, and there is no evidence to suggest hereditary transmission [5,[7][8][9]. Malignant transformation has not yet been reported [4,5,[9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

TKA in the treatment of bilateral dysplasia epiphysealis hemimelica (Trevor’s Disease) of the knee in a 50-year-old man: a case report

Gao

Guo

Wang

et al. 2020

BMC Musculoskelet Disord

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Dysplasia epiphysealis hemimelica of the lower limb

et al. 2016

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Dysplasia epiphysealis hemimelica (DEH) is a rare developmental disorder characterized by osteocartilaginous overgrowth in one or more epiphyses. The disease usually involves a single limb or is hemimelic (lateral or medial compartment), and lower extremities are more frequently affected than upper extremities. Here we present clinical and radiological findings for a male DEH patient at 1.5 and 3.5 years of age. The radiographs obtained at first presentation showed minimal osseous overgrowth and irregularity at the epiphyses around the left knee and ankle joints, respectively. Radiographs obtained at the second presentation showed osteocartilaginous masses at most epiphyses of the left lower extremity. Two months after diagnosis (at 3.7 years old), the patient had surgery on his left knee to relieve increased joint restriction. The histopathological diagnosis was consistent with an osteocartilaginous lesion. This case report presents imaging features and age-related progression of DEH in this patient.

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Tarsal tunnel syndrome secondary to osteochondroma of the calcaneus: a case report

Won

Kim

Min

et al. 2020

BMC Musculoskelet Disord

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Background: Tarsal tunnel syndrome is an entrapment neuropathy that can be provoked by either intrinsic or extrinsic factors that compresses the posterior tibial nerve beneath the flexor retinaculum. Osteochondroma, the most common benign bone tumor, seldom occur in foot or ankle. This is a rare case of tarsal tunnel syndrome secondary to osteochondroma of the sustentaculum tali successfully treated with open surgical excision. Case presentation: A 15-year-old male presented with the main complaint of burning pain and paresthesia on the medial plantar aspect of the forefoot to the middle foot region. Hard mass-like lesion was palpated on the posteroinferior aspect of the medial malleolus. On the radiological examination, 2.5 × 1 cm sized bony protuberance was found below the sustentaculum tali. Surgical decompression of the posterior tibial nerve was performed by complete excision of the bony mass connected to the sustentaculum tali. The excised mass was diagnosed to be osteochondroma on the histologic examination. After surgery, the pain was relieved immediately and hypoesthesia disappeared 3 months postoperatively. Physical examination and radiographic examination at 2-year follow up revealed that tarsal tunnel was completely decompressed without any evidence of complication or recurrence. Conclusions: As for tarsal tunnel syndrome secondary to the identifiable space occupying structure with a distinct neurologic symptom, we suggest complete surgical excision of the causative structure in an effort to effectively relieve symptoms and prevent recurrence.

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Dysplasia Epiphysealis Hemimelica (Trevor Disease) of the Ankle

Abstract: An 11-year-old boy presented with a 2-year history of left ankle pain and abnormal gait, worsened with sports activities such as football and wrestling.

Cited by 7 publications

References 6 publications

TKA in the treatment of bilateral dysplasia epiphysealis hemimelica (Trevor’s Disease) of the knee in a 50-year-old man: a case report

TKA in the treatment of bilateral dysplasia epiphysealis hemimelica (Trevor’s Disease) of the knee in a 50-year-old man: a case report

Dysplasia epiphysealis hemimelica of the lower limb

Tarsal tunnel syndrome secondary to osteochondroma of the calcaneus: a case report

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