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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0041-1739402
Relato de Caso

Van Neck-Odelberg Disease — A Rare or Underdiagnosed Condition?

Article in several languages: português | English
Mafalda Moreira 
1   Serviço de Pediatria e Neonatologia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
,
Diana Alba 
1   Serviço de Pediatria e Neonatologia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
,
Hélder Nogueira 
1   Serviço de Pediatria e Neonatologia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
,
Sandra Teixeira 
1   Serviço de Pediatria e Neonatologia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
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Abstract

Van Neck-Odelberg (VNO) disease is a rare osteochondrosis affecting the ischiopubic synchondrosis (IPS). This condition should be included in the differential diagnosis of children with lameness, inguinal pain, and functional limitation of the hip. In imaging tests, it is characterized by asymmetric IPS hypertrophy. We present the clinical case of a 4-year-old child, previously healthy, who visited the emergency department for left inguinal pain and lameness starting on the same day. There was no previous history of trauma or changes in inflammatory parameters. The patient underwent a pelvic radiography and magnetic resonance imaging (MRI), which revealed a radiopaque image with well-defined contours in the left ischiopubic branch, and IPS swelling. With a presumed diagnosis of VNO disease, the patient was medicated symptomatically, with complete recovery in 10 days. Lameness is a frequent reason for medical evaluation in the pediatric population. In subjects up to 5 years old, the most common causes of lameness include transient hip synovitis, septic arthritis, and Legg-Calvé-Perthes disease. In the absence of a history of trauma or infection-related clinical findings, VNO disease should be considered as a hypothesis. Its diagnosis requires a pelvic radiography, usually showing a unilateral fusiform opacification at the ischial level; an MRI may be necessary. The recommended treatment is conservative, with symptomatic recovery in 2 weeks. The knowledge and diagnosis of VNO disease allow a targeted approach, without the emotional burden for the patient and his/her family that may be associated to other conditions.

Keywords

osteochondrosis - child - intermittent claudication

Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Study performed at Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.




Publication History

Received: 14 December 2020

Accepted: 11 February 2021

Article published online:
20 January 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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