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Case Reports
. 2018 Jul 26:6:2050313X18790166.
doi: 10.1177/2050313X18790166. eCollection 2018.

Arthroscopic treatment of intra-articular dysplasia epiphysealis hemimelica of the knee

Takeo Mammoto  1 , Atsushi Hirano  1
Affiliations
Case Reports

Arthroscopic treatment of intra-articular dysplasia epiphysealis hemimelica of the knee

Takeo Mammoto et al. SAGE Open Med Case Rep. .

Abstract

Dysplasia epiphysealis hemimelica, also known as Trevor Fairbank disease, is characterized by asymmetrical osteochondral overgrowth of the epiphyseal cartilage. The clinical presentation of dysplasia epiphysealis hemimelica is wide and variable, depending on the site of the lesion. Herein, we describe the physical examination of a 9-year-old boy with intra-articular dysplasia epiphysealis hemimelica, in whom the symptoms were elicited on "reverse Wilson's sign": bending the knee from 70° to 120° against resistance while externally rotating the tibia. Arthroscopic treatment of the intra-articular dysplasia epiphysealis hemimelica of the knee showed good outcome; hence, this modality should be considered for the management of intra-articular dysplasia epiphysealis hemimelica.

Keywords: Dysplasia epiphysealis hemimelica; Trevor disease; Wilson’s sign.

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Conflict of interest statement

Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Plain radiograph showing irregular exophytic ossification at the posteromedial side of the medial femoral condyle of the right knee.
Figure 2.
Figure 2.
Computed tomography (CT) images revealed lobulated irregular osseous hypertrophy of the medial side of the medial femoral epiphyses: coronal (a), sagittal (b), axial (c), and volume rendering imaging (d).
Figure 3.
Figure 3.
Magnetic resonance imaging showing asymmetrical osteocartilaginous lesions, continuous with the distal femoral epiphyses: coronal view of T2*-weighted image (WI) (a), sagittal view of fat suppression proton-density WI (b), and T2*-WI (c), and axial view of T2 turbo spin echo WI (d).
Figure 4.
Figure 4.
Arthroscopic findings: (a) protuberance of the cartilage surface was seen at the posterior medial femoral condyle (MFC) without cartilage injury. (b) The extensive chondral protuberance of the MFC was over-riding the posterior horn of the medial menisci during deep knee flexion. (c) The protruding region was impinging on the posterior medial tibia during internal rotation of the knee, and the locking phenomenon was elicited. (d) After arthroscopic removal and contouring of the posteromedial protuberance, impinging was eliminated during full range of motion.
See this image and copyright information in PMC

References

    1. Trevor D. Tarso-epiphysial aclasis a congenital error of epiphysial development. J Bone Joint Surg Br 1950; 32-B(2): 204–213. - PubMed
    1. Fairbank TJ. Dysplasia epiphysialis hemimelica (tarso-ephiphysial aclasis). J Bone Joint Surg Br 1956; 38-B(1): 237–257. - PubMed
    1. Celikyay RY, Celikyay F, Bilgic E, et al. Dysplasia epiphysealis hemimelica of the lower limb. Skeletal Radiol 2017; 46(1): 111–115. - PubMed
    1. Wilson JN. A diagnostic sign in osteochondritis dissecans of the knee. J Bone Joint Surg Am 1967; 49(3): 477–480. - PubMed
    1. Tyler PA, Rajeswaran G, Saifuddin A. Imaging of dysplasia epiphysealis hemimelica (Trevor’s disease). Clin Radiol 2013; 68(4): 415–421. - PubMed

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