Heather Borders, MD
over 6 years ago
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Joseph Junewick, MD FACR
|Diagnostic Category: Neoplasia Benign
|Created: over 3 years ago
|Updated: 9 months ago
11Y M with chronic left ankle pain.
CR – intraarticular osteochondroma or loose body.
CT and MRI – protuberant osseous lesion arising from the medial talus with ligamentous displacement and articular/subchondral irregularity of the talus and tibia.
Trevor’s disease (Dysplasia epiphysealis hemimelica, Fairbank’s, or Trevor Fairbank disease) is a rare developmental skeletal disorder believed due to congenital error of limb bud development.
It is characterized by intraarticular lesions arising from epiphysis, histologically resembling osteochondroma. They contain bands of cartilage separating areas of cancellous bone. A single limb is affected, usually lower extremity (ankle most common), medial more than lateral, and usually more than 1 joint, but it may be monoarticular or all joints of an extremity.
The incidence is 1 per million, 3:1 male:female, and arises during childhood. The disorder is benign, but can lead to complications of early physeal closure, malalignment, or early osteoarthritis. MRI imaging shows a cartilaginous lesion, with signal matches adjacent epiphysis. Treatment is surgical resection, occasionally with osteotomy to regain proper alignment.
Tyler PA. Imaging of dysplasia epiphysealis hemimelica (Trevor’s disease). Clinical Radiology. Volume 68, Issue 4, April 2013, p 415-421.
Aaron Massie, MD