Images in Clinical Rheumatology
Van Neck-Odelberg Disease: Another Cause of Limp in Childhood
Enfermedad de Van Neck-Odelberg: una causa más de cojera en la infancia
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Signal alteration in bone marrow and edema of the surrounding soft tissue.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Ischiopubic synchondrosis (IPS) is a temporary joint that exists only in childhood, during bone maturation. On occasion it produces pain, whereas on others, it is an incidental finding revealed by plain radiography. Given its tumor-like aspect, it is necessary to perform magnetic resonance imaging (MRI) to differentiate it from pathological conditions.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case Report</span><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was an 8-year-old boy with no significant medical history. He reported that, for the last year, he was having weekly episodes of intense pain in right lower limb that lasted at least an hour. The pain was located in anterior aspect of his thigh and gluteal region, and limited his mobility. He had no fever or constitutional symptoms. The clinical signs and symptoms remitted with rest and the usual analgesics.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Physical examination confirmed that the child was obese (body mass index<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>24; >97th percentile). There was no evidence of inflammation, limitation of mobility or neurological deficits. Complete blood count, laboratory tests and acute-phase reactants were normal.</p><p id="par0020" class="elsevierStylePara elsevierViewall">An anteroposterior radiograph of the pelvis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) revealed enlargement of right-sided IPS, with small irregularities of pseudotumoral aspect. Magnetic resolution produced (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) an asymmetrical and irregular image, like a “fibrous bridge”, affecting right ischiopubic syndesmosis (T1) and a hyperintense signal with associated soft-tissue edema in T2-weighted and short tau inversion recovery (STIR) sequences. This is all compatible with a diagnosis of “Van Neck-Odelberg osteochondritis”.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">Van Neck-Odelberg disease is a benign process that develops in children between the ages of 4 and 16 years. It is characterized by pain in the lower limb due to osteochondritis of the ischiopubic ramus.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">There is swelling of the IPS with no clinical manifestations, but it can be associated with pain in the thigh, groin region or buttock, with limitation of the mobility of the extremity and limping.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Plain radiography usually shows an enlargement of the synchondrosis with radiolucent and osteolytic areas. The typical MRI findings include changes in bone marrow and perilesional soft-tissue edema.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2–4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The tumor-like appearance in radiographs may lead to a diagnosis of stress fracture, an infectious process or tumor.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1–5</span></a> The absence of fever and normal results on laboratory tests facilitates the differential diagnosis.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">This condition usually has a favorable outcome after 2 or 3 weeks of anti-inflammatory therapy and rest.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3,5,6</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Ethical Disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Protection of human and animal subjects</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Confidentiality of data</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Right to privacy and informed consent</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of Interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Case Report" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 3 => array:3 [ "identificador" => "sec0020" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Right to privacy and informed consent" ] ] ] 4 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of Interest" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-12-23" "fechaAceptado" => "2016-07-11" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Morante Bolado I, Ortega Navaridas M, Clemente Garulo D, López Robledillo JC. Enfermedad de Van Neck-Odelberg: una causa más de cojera en la infancia. Reumatol Clin. 2017;13:299–300.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 740 "Ancho" => 1030 "Tamanyo" => 76081 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Anteroposterior radiograph of pelvis: swelling of right ischiopubic synchondrosis.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 643 "Ancho" => 1040 "Tamanyo" => 88738 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Axial magnetic resonance imaging (short tau inversion recovery) of pelvis: swelling of right ischiopubic synchondrosis, with irregular margins. Signal alteration in bone marrow and edema of the surrounding soft tissue.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Van Neck disease: osteochondrosis of the ischiopubic synchondrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Wait" 1 => "T. Gaskill" 2 => "Z. Sarwar" 3 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 72 | 14 | 86 |
| 2024 October | 659 | 63 | 722 |
| 2024 September | 422 | 44 | 466 |
| 2024 August | 409 | 53 | 462 |
| 2024 July | 592 | 64 | 656 |
| 2024 June | 401 | 58 | 459 |
| 2024 May | 392 | 62 | 454 |
| 2024 April | 301 | 50 | 351 |
| 2024 March | 372 | 59 | 431 |
| 2024 February | 409 | 33 | 442 |
| 2024 January | 606 | 46 | 652 |
| 2023 December | 477 | 40 | 517 |
| 2023 November | 409 | 44 | 453 |
| 2023 October | 524 | 39 | 563 |
| 2023 September | 323 | 58 | 381 |
| 2023 August | 394 | 27 | 421 |
| 2023 July | 480 | 46 | 526 |
| 2023 June | 307 | 37 | 344 |
| 2023 May | 301 | 31 | 332 |
| 2023 April | 281 | 26 | 307 |
| 2023 March | 423 | 38 | 461 |
| 2023 February | 349 | 31 | 380 |
| 2023 January | 345 | 28 | 373 |
| 2022 December | 283 | 49 | 332 |
| 2022 November | 349 | 52 | 401 |
| 2022 October | 330 | 52 | 382 |
| 2022 September | 325 | 58 | 383 |
| 2022 August | 290 | 61 | 351 |
| 2022 July | 260 | 54 | 314 |
| 2022 June | 469 | 50 | 519 |
| 2022 May | 308 | 63 | 371 |
| 2022 April | 337 | 74 | 411 |
| 2022 March | 375 | 83 | 458 |
| 2022 February | 428 | 62 | 490 |
| 2022 January | 381 | 64 | 445 |
| 2021 December | 272 | 62 | 334 |
| 2021 November | 297 | 62 | 359 |
| 2021 October | 297 | 78 | 375 |
| 2021 September | 222 | 49 | 271 |
| 2021 August | 216 | 49 | 265 |
| 2021 July | 184 | 50 | 234 |
| 2021 June | 292 | 56 | 348 |
| 2021 May | 291 | 60 | 351 |
| 2021 April | 392 | 108 | 500 |
| 2021 March | 244 | 45 | 289 |
| 2021 February | 193 | 33 | 226 |
| 2021 January | 141 | 28 | 169 |
| 2020 December | 135 | 32 | 167 |
| 2020 November | 187 | 36 | 223 |
| 2020 October | 133 | 18 | 151 |
| 2020 September | 192 | 55 | 247 |
| 2020 August | 148 | 27 | 175 |
| 2020 July | 113 | 14 | 127 |
| 2020 June | 83 | 26 | 109 |
| 2020 May | 48 | 9 | 57 |
| 2020 April | 33 | 19 | 52 |
| 2020 March | 14 | 9 | 23 |
| 2020 February | 1 | 0 | 1 |
| 2020 January | 1 | 0 | 1 |
| 2019 July | 1 | 2 | 3 |
| 2019 March | 1 | 0 | 1 |
| 2019 February | 6 | 0 | 6 |
| 2019 January | 1 | 0 | 1 |
| 2018 December | 2 | 0 | 2 |
| 2018 October | 0 | 1 | 1 |
| 2018 May | 15 | 0 | 15 |
| 2018 April | 150 | 9 | 159 |
| 2018 March | 99 | 9 | 108 |
| 2018 February | 74 | 10 | 84 |
| 2018 January | 96 | 8 | 104 |
| 2017 December | 56 | 11 | 67 |
| 2017 November | 82 | 16 | 98 |
| 2017 October | 80 | 37 | 117 |
| 2017 September | 72 | 32 | 104 |
| 2017 August | 37 | 23 | 60 |
| 2017 July | 2 | 9 | 11 |
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