Po718 A Case : Ischiopubic Synchondrosis Stress Injury

Conference: 
Author(s): 
AYKUT AYTEKIN1, ADEM PARLAK2 e MEHMET MURAT SEVEN
1Bal?kesir Military Hospital, Department of Radiology; 2Gulhane School of Medicine, Department of Family Medicine
Text: 
Introduction: The ischiopubic synchondrosis syndrome (IPS) or van Neck-Odelberg disease is a rare condition characterized by an ossification pattern involving the ischiopubic synchondrosis where is appears enlarged. An enlarged ischiopubic synchondrosis is a frequently found imaging observation and occurs in all children before puberty during fusion of the pubic and ischium bones. While it is considered as a normal developmental process, it is sometimes termed a syndrome in children who have associated symptoms such as groin pain. The case with IPS is presented because of a rare disorder. Case: A 11 year-old girl was admitted to our clinic with left hip pain. The case had hip pain for 10 days and did not have a history of trauma or infection. Vital signs were stable. There was no swelling and tenderness on palpation of the ischiopubic synchondrosis region. The patient’s left hip adductor muscle contraction is mild and the left hip joint range of motion was found to be limited. CRP was 21 mg and sedimentation rate was 32 mm/hour, complete blood count was normal. Perthes disease and synovitis was considered in differential diagnosis. Anteroposterior pelvic radiograph were normal. And then magnetic resonance imaging (MRI) was performed. MRI examination revealed no pathological findings in the left hip joint. But left ischiopubic synchondrosis and adjacent bone marrow had edema. There were no synchondrosis expansion and fracture in the study. Adductor and obturator muscles had grade 1 strain. Patient were treated conservatively, were given anti-inflammatories and analgesics and recommended to avoid heavy sports and exercise. One week later, in the examination due to a decline in complaint and findings surgical approach was not required. Conclusion: Synchondrosis ossification is an asymptomatic process though in some children groin pain and restriction of hip mobility may be present. In this context, it is frequently found on pelvic radiographs as a unilateral enlarged and fusiform tumour-like image. The scenario for parental apprehension is set and most times, if symptoms don’t resolve, a differential diagnose should be considered including stress fracture, post traumatic osteolysis, osteomyelitis or neoplasia.
Literature: 
PO718 A CASE : ISCHIOPUBIC SYNCHONDROSIS STRESS INJURY
Keywords: 
synchondrosis, ischiopubic, injury