Van Neck–Odelberg disease: A rare cause of pain in pediatric pelvis

Abstract

Van Neck-Odelberg disease or ischiopubic osteochondritis, is a rare cause of pain in the pediatric pelvis due to late closure in synchondrosis ischiopubic, whose main symptom is an asymmetric pain that can cause a limitation in movement or limp. The different characteristics by images from simple radiography, computed tomography, MRI and bone scintigraphy scan will increase certainty diagnosis and will allow the correct differential diagnosis with fractures, posttraumatic osteolysis, infections or tumors, that leads to unnecessary invasive procedures, this being a benign disease with an evolution and improvement that occurs in weeks or months with conservative treatment. A case of a 15-year-old boy who consulted our hospital with an extra-institutional diagnosis of right ischiopubic fracture. After being evaluated by different imaging methods, a diagnosis of Van Neck-Odelberg or ischiopubic osteochondritis was made.

Bilateral Van Neck-Odelberg Disease: A Case Report

“…These joints usually fuse or close asymmetrically rather than simultaneously. Therefore, an enlarged IPS is sometimes seen in older children before complete ossification [ 12 ]. As published in the literature, unbalanced mechanical stress, such as jumping or kicking, may result in an inflammatory reaction, which could delay the complete ossification of this synchondrosis, producing symptoms [ 3 , 6 , 7 ].…”

“…Radiological investigations such as X-ray and CT classically show increased size with sclerosis or lucency [ 3 ]. MRI is more sensitive and can help make early diagnoses [ 12 ]. Classically, there is an increase in signal intensity in T2 sequences with fatty saturation or short-tau inversion recovery due to bone edema at the site of synchondrosis, with evidence of cartilage and bone bridges inside [ 12 ].…”

“…MRI is more sensitive and can help make early diagnoses [ 12 ]. Classically, there is an increase in signal intensity in T2 sequences with fatty saturation or short-tau inversion recovery due to bone edema at the site of synchondrosis, with evidence of cartilage and bone bridges inside [ 12 ]. It plays a vital role in ruling out a neoplasm, such as Ewing’s sarcoma, and increasing the diagnostic certainty [ 6 , 12 ].…”

“…Classically, there is an increase in signal intensity in T2 sequences with fatty saturation or short-tau inversion recovery due to bone edema at the site of synchondrosis, with evidence of cartilage and bone bridges inside [ 12 ]. It plays a vital role in ruling out a neoplasm, such as Ewing’s sarcoma, and increasing the diagnostic certainty [ 6 , 12 ]. Differential diagnosis can be difficult as it can resemble pubic rami stress fractures, which are one of the typical lesions and usually occur in athletes or after radiation therapy [ 3 , 6 , 13 ].…”

Van Neck-Odelberg Disease: A Rare Cause of Pediatric Hip Pain

“…This normal process of ossification is typically asymptomatic. However, delayed ossification may lead to pain in the hip area, restriction of hip movement, or limp [ 9 ].…”