Ischiopubic Osteochondrosis (Van Neck-Odelberg Disease) as a Rare Cause of Pediatric Hip Pain: A Systematic Review

Abstract

Overgrowth of the ischiopubic synchondrosis, a junction between the inferior pubic ramus and ischium, leads to the development of Van Neck-Odelberg disease. This condition is a rare cause of pediatric hip pain and limping that is often misdiagnosed due to its rarity and non-specific presentation. A review of the literature was conducted on PubMed, Cochrane, Embase, and Web of Science to identify case reports and case series of Van Neck-Odelberg disease using the keywords "Van Neck-Odelberg Disease" and "Ischiopubic Osteochondrosis." A total of 115 studies were identified. After applying exclusion criteria, 15 studies remained. Most patients were male (n = 16; 84.2%), and the median age was 12 years (range = 5.5-17 years). The most common presenting symptoms were groin pain (n = 16; 84.2%), limping and gait limitation (n = 9; 47.4%), and restricted hip range of motion (n = 4; 21.1%). The most common differential diagnoses were fractures (n = 7; 36.8%), ischial ramus tumors (n = 6; 31.6%), and osteomyelitis (n = 5; 26.3%). The median time to symptom resolution was eight weeks, with most patients achieving complete resolution of symptoms. The major challenge with this condition is preventing misdiagnosis of pediatric patients. The most common misdiagnosis was a fracture. Understanding the anatomy of physiology of the pediatric hip and raising awareness of this rare condition will likely benefit physicians struggling to make this diagnosis. Recognizing common presenting signs of Van Neck-Odelberg disease and diagnostic imaging features will allow physicians to make the correct initial diagnosis, potentially preventing invasive treatments in pediatric patients.

Keywords: musculoskeletal imaging; non-surgical orthopedics; orthopedics & traumatology; pediatric hip pain; pediatric orthopedic surgery.

Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart detailing the literature search and data selection process.