Imaging of dysplasia epiphysealis hemimelica (Trevor's disease)

Tyler, Philippa; Rajeswaran, Gajan; Saifuddin, Asif

doi:10.1016/j.crad.2012.08.010

Cited by 39 publications

(29 citation statements)

References 19 publications

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“…Sometimes it can be difficult to differentiate between DEH and parosteal osteosarcoma and osteoblastoma, especially in the early stages [6, 27] and if the talus is affected, since it may remain separated from the host bone [28]. CT is very useful in identifying calcification or ossification within the DEH lesion and to define cortical and medullar continuity between the lesion and the adjacent bone [27, 29]. Also, 3-dimensional reconstructions of the CT images can be helpful in the preoperative planning [23].…”

Section: Discussionmentioning

confidence: 99%

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Trevor’s Disease: A Literature Review regarding Classification, Treatment, and Prognosis apropos of a Case

Arealis

Nikolaou

Lacon

et al. 2014

Case Reports in Orthopedics

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Background. Dysplasia epiphysealis hemimelica (DEH) is rare and its main characteristic is osteochondromas of the epiphysis of long bones. Methods. We report a case of DEH of the ankle in an 8-year-old boy that was resected in 2005. Additionally we collect all the reported cases of DEH. The literature is reviewed regarding the treatment, prognosis, long term function, and patterns and areas affected by DEH. Results. In our case no complications were noted and our patient remains asymptomatic. Reviewing the literature we found that 73 authors have reported 144 cases from 1926 to 2013. We propose and describe a new classification that correlates with prognosis. According to our classification DEH is classified as types 1 with single lower limb involvement, 2 with multiple lower limb, 3 with single upper limb, 4 with multiple upper limb, 5 with upper and lower limb, and 6 with spine. Conclusions. All single lesions should be followed up and if indicated a whole body nuclear bone scan can be useful in identifying the existence of multiple affected joints. Type 1 lesions have better prognosis than 2 and have less chances of developing OA even if not resected. Resection, even if partial, can be a successful treatment for DEH.

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Section: Discussionmentioning

confidence: 99%

“…Additionally it provides information regarding the involvement of the epiphysis, the surrounding soft tissues, and the joint [4, 29]. The DEH mass has a low to intermediate signal on T1 weighted images and high signal on T2.…”

Section: Discussionmentioning

confidence: 99%

Trevor’s Disease: A Literature Review regarding Classification, Treatment, and Prognosis apropos of a Case

Arealis

Nikolaou

Lacon

et al. 2014

Case Reports in Orthopedics

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“…Axial T1 post-contrast image b shows irregular peripheral contrast enhancement of the lesion without surrounding soft-tissue invasion ( arrow ). The lesion is hypointense on coronal T1 c and mostly hyperintense with few hypointense foci on axial T2 d ( black arrow ) Dysplasia epiphysealis hemimelica (DEH):This is also known as Trevor’s or Trevor–Fairbank disease and is a rare developmental disorder of the skeleton characterized by asymmetric osteochondral overgrowth of a medial or lateral epiphysis or epiphyseal equivalent [15]. This most frequently affects the knee and ankle, presents as a hard, painless mass adjacent to the affected joint with pain/discomfort developing at a later stage.…”

Section: Introductionmentioning

confidence: 99%

“…Affected epiphysis is usually larger than that of the contralateral normal limb. Associated metaphyseal widening and remodelling may occur [15]. …”

Section: Introductionmentioning

confidence: 99%

Lesions involving the outer surface of the bone in children: a pictorial review

et al. 2016

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BackgroundLesions involving the outer cortical surface of the bone occur quite often among children. Broadly, these include benign cortical, juxtacortical and periarticular lesions, dysplasias affecting the cortical bone, regional and diffuse periosteal pathology and malignant tumours. Some of these lesions are unique to the paediatric population; others are more frequently seen among children than adults — yet others have an adult predilection but can occasionally be seen in children.MethodsA complete list of differential considerations for lesions involving the outer cortical surface of the bone in children is presented. Imaging characteristics on plain film radiography and MR are described in association with multiple examples and illustrations.ConclusionA pictorial review detailing the imaging features of surface lesions of the bone in children will be a useful aide for both radiologists and their clinical colleagues, and will help them sort their way through the maze of differential diagnoses for these abnormalities. Teaching Points • Surface lesions of bones in children comprise a distinct entity and differ from those in adults. • Imaging plays an important role towards classifying surface lesions of bones in children. • MRI features may be characteristic and aid precise diagnosis, thus guiding further management.

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“…Complications include local pressure symptoms and internal derangement. Malignant transformation has never been reported in the literature [4].…”

mentioning

confidence: 96%