Age / Sex : 5 / F

Chief complaint: Palpable mass

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Courtesy: Ho-Taek Song, Yonsei University Severance Hospital

Dysplasia epiphysealis hemimelica (Trevor's disease)

Discussion

Findings:

Plain radiograph: Multiple irregular ossified mass lesions at the epiphysis of distal ulnar.

MRI: Osteochondral overgrowth showing enlarged and partly ossified mass lesion at the epiphysis of the ulna with signal intensity similar to normal epiphyseal cartilage and bone.

Differential Diagnosis:

Synovial osteochondromatosis

Osteochondroma

Diagnosis:  

Dysplasia epiphysealis hemimelica (Trevor's disease)


Discussion:

Uncertain etiology.

Most common symptom is painless mass around affected joint

Histologically resembles osteochondromas

Male predilection

Commonly affect medial aspect of distal end of lower extremity.

Classification in 3 groups:

(1) localized, affecting only one epiphysis

(2) classic (most common), affecting more than one epiphysis in the same limb

(3) generalized, involving the whole lower limb

Tx: Surgical excision

References:

Rosero VM, Kiss S, Terebessy T, et al. Dysplasia epiphysealis hemimelica (Trevor's disease): 7 of our own cases and a review of the literature. Acta Orthop. 2007 Dec;78(6):856-61.

Volders D1, Vandevenne JE, Van de Casseye W. Trevor's disease and whole-body MRI. Eur J Radiol. 2011 Sep;79(3):363-4.