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. 2024 Oct 28;32(5):e278967.
doi: 10.1590/1413-785220243205e278967. eCollection 2024.

MEYER'S DYSPLASIA IN THE DIFFERENTIAL DIAGNOSIS OF HIP PAIN IN CHILDHOOD

Fabio Carramão Narimatsu  1 , Pedro Alcantara Barroso  1 , Alceu José Fornari Gomes Chueire  2 , Paulo Humberto Mem Martendal Costa  3 , Miguel Akkari  3 , Claudio Santili  4
Affiliations

MEYER'S DYSPLASIA IN THE DIFFERENTIAL DIAGNOSIS OF HIP PAIN IN CHILDHOOD

Fabio Carramão Narimatsu et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Objective: This study reviews the literature and shares clinical experiences, emphasizing its diagnostic relevance in children under 5 years of age.

Method: We examined 169 cases of Legg-Calvé-Perthes disease (LCPD) in patients in this age group. We analyzed medical records and images, observing variables such as age, gender, complaints, treatment, and outcomes.

Results: We studied 20 patients with Meyer's dysplasia, representing 1.4% of LCPD cases in children. The majority were boys (85%) with symptom onset at 38 months. Claudication (25%) and mild pain (40%) were the main complaints. Radiographic findings showed a smaller, granular, or asymmetric nucleus. The average follow-up was 6.4 years, with interventional treatment in 5 cases. Most showed complete reossification and centralization of the femoral head.

Conclusion: Meyer's dysplasia is a rare condition that affects the hip in children under 5 years of age, predominantly in boys. It usually does not require intensive treatment; clinical and radiological follow-up is sufficient. However, it is important to be aware of possible unfavorable progressions, requiring more aggressive treatment to prevent complications. Level of evidence III, Retrospective comparative study.

Objetivo: Este estudo objetiva revisar a literatura e compartilhar experiências clínicas, enfatizando sua relevância diagnóstica em crianças com menos de 5 anos. Método: Estudamos 169 casos de Doença de Legg-Calvé-Perthes (DLCP) em pacientes desta faixa etária. Analisamos prontuários e imagens, observando variáveis como idade, gênero, queixas, tratamento e resultados.

Resultados: Estudamos 20 pacientes com displasia de Meyer, que representavam 1,4% dos casos de DLCP em crianças. A maioria eram meninos (85%) com início dos sintomas aos 38 meses. Claudicação (25%) e dor leve (40%) foram as principais queixas. Achados radiográficos mostraram núcleo menor, granular ou assimétrico. O acompanhamento médio foi de 6,4 anos, com tratamento intervencionista em cinco dos casos. A maioria apresentou reossificação completa e centralização da cabeça femoral. Conclusão: A Displasia de Meyer é uma condição rara que afeta o quadril em crianças menores de 5 anos, predominantemente em meninos. Geralmente, não requer tratamento intensivo; os acompanhamentos clínico e radiológico são suficientes. Contudo, é importante estar ciente de possíveis evoluções desfavoráveis, requerendo tratamento mais agressivo para evitar sequelas. Nível de Evidência III, Estudo restrospectivo comparativo.

Keywords: Hip; Hip Joint; Intermittent Claudication; Legg-Calve-Perthes Disease.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1.
Figure 1.. Radiographs of pelvis in anteroposterior orientation illustrating the patterns of involvement in Meyer’s epiphysitis - A – asymmetric pattern; B – granular pattern; C - mixed pattern.
Figure 2.
Figure 2.. X-ray of the pelvis (anteroposterior view) at the initial examination at 3 years and 8 months old.
Figure 3.
Figure 3.. Radiograph of the pelvis (anteroposterior view) at the final examination at 11 years and 11 months.
See this image and copyright information in PMC

References

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