Trevor disease (Hemimelic epiphyseal displasia): 12-year follow-up case report and literature review

Abstract

Trevor disease or hemimelic epiphyseal dysplasia is a rare skeletal developmental disorder characterized by asymmetric overgrowth of cartilage in the epiphyses. Histologically, it is an epiphysis osteochondroma. The symptom onset occurs primarily during childhood. Males are 3 times more affected than females. The most common symptom is a painless bony mass around the ankle or knee, followed by swelling, restricted range of motion and deformity. Imaging diagnosis is based on plain radiographs, computed tomography scans and magnetic resonance imaging. Treatment depends on the deformities, symptoms, location and amount of epiphysis involvement. Asymptomatic patients require no treatment. When no deformities are identified, simple mass excision is the treatment choice. If the mass causes epiphyses asymmetry, resection must be combined with osteotomies. The present study reports a case of Trevor disease in a female patient with 12-year follow-up. A general review of Trevor disease was also performed.

Bilateral Toe Walking as Presentation of Unilateral Dysplasia Epiphysealis Hemimelica of the Ankle

“…During growth, the ossification centers become asymmetric, intra-articular bony exostosis 2,3 . The most common initial presentation includes a painless mass of the ankle or knee, local swelling, and loss of range of motion 9 . Although DEH is benign, it can be locally aggressive and especially detrimental around the ankle 3 .…”