Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;92(3):347-351.
doi: 10.1080/17453674.2021.1882237. Epub 2021 Feb 4.

Invasive diagnostic and therapeutic measures are unnecessary in patients with symptomatic van Neck-Odelberg disease (ischiopubic synchondrosis): a retrospective single-center study of 21 patients with median follow-up of 5 years

Kristian Nikolaus Schneider  1 , Lukas Peter Lampe  1 , Georg Gosheger  1 , Christoph Theil  1 , Max Masthoff  2 , Robert Rödl  1 , Björn Vogt  1 , Dimosthenis Andreou  1
Affiliations

Invasive diagnostic and therapeutic measures are unnecessary in patients with symptomatic van Neck-Odelberg disease (ischiopubic synchondrosis): a retrospective single-center study of 21 patients with median follow-up of 5 years

Kristian Nikolaus Schneider et al. Acta Orthop. 2021 Jun.

Abstract

Background and purpose - Van Neck-Odelberg disease (VND) is a self-limiting skeletal phenomenon characterized by a symptomatic or asymptomatic uni- or bilateral overgrowth of the pre-pubescent ischiopubic synchondrosis. It is frequently misinterpreted as a neoplastic, traumatic, or infectious process, often resulting in excessive diagnostic and therapeutic measures. This study assessed the demographic, clinical, and radiographic features of the condition and analyzed diagnostic and therapeutic pathways in a large single-center cohort.Patients and methods - We retrospectively analyzed 21 consecutive patients (13 male) with a median age of 10 years (IQR 8-13) and a median follow-up of 5 years (IQR 42-94 months), who were diagnosed at our department between 1995 and 2019.Results - VND was unilateral in 17 cases and bilateral in 4 cases. Initial referral diagnoses included suspected primary bone tumor (n = 9), fracture (n = 3), osteomyelitis (n = 2), and metastasis (n = 1). The referral diagnosis was more likely to be VND in asymptomatic than symptomatic patients (4/6 vs. 2/15). More MRI scans were performed in unilateral than bilateral VND (median 2 vs. 0). All 15 symptomatic patients underwent nonoperative treatment and reported a resolution of symptoms and return to physical activity after a median time of 5 months (IQR 0-6).Interpretation - By understanding the physiological course of VND during skeletal maturation, unnecessary diagnostic and therapeutic measures can be avoided and uncertainty and anxiety amongst affected patients, their families, and treating physicians can be minimized.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Typical enlargement of the IPS in a 14-year-old female patient with right-sided VND.
Figure 2.
Figure 2.
CT scan showing enlargement of the left IPS in a 16-year-old female patient with VND.
Figure 3.
Figure 3.
Standardized algorithm in our institute for diagnosis and treatment of VND.
Figure 4.
Figure 4.
Bilateral VND in a 10-year-old female patient with right-sided Legg–Calvй–Perthes disease (A). Complete dissolution of the bilateral VND at 4-year follow-up (B).
Figure 5.
Figure 5.
T2-weighted MRI scan with a left-sided VND suspicious of osteomyelitis in a 7-year-old male patient.
Figure 6.
Figure 6.
VND in a 22-year-old female patient.
See this image and copyright information in PMC

References

    1. Byers P D. Ischio-pubic ‘osteochondritis’: a report of a case and a review. J Bone Joint Surg Br 1963; 45(4): 694–702. - PubMed
    1. Cawley K A, Dvorak A D, Wilmot M D.. Normal anatomic variant: scintigraphy of the ischiopubic synchondrosis. J Nucl Med 1983; 24(1): 14–16. - PubMed
    1. Ceroni D, De Coulon G, Regusci M, Kaelin A.. Gorham–Stout disease of costo-vertebral localization: radiographic, scintigraphic, computed tomography, and magnetic resonance imaging findings. Acta Radiol 2004; 45(4): 464–8. - PubMed
    1. Drubach L A, Voss S D, Kourmouzi V, Connolly L P.. The ischiopubic synchondrosis: changing appearance on PET/CT as a mimic of disease. Clin Nucl Med 2006; 31(7): 414–7. - PubMed
    1. Gregory L S, Jones L V, Amorosi N M.. Assessing the fusion of the ischiopubic synchondrosis using predictive modeling. Clin Anat 2019; 32(6): 851–9. - PubMed

Publication types

LinkOut - more resources