Fact-sheet: Osteochondritis ischiopubica - Van Neck Odelberg disease
Updated on 04/02/2020 at 8:53 AM
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Definition
Osteochondrosis of the ischiopubic synchondrosis affecting children aged 4 to 10 years.
Clinical features
This ischiopubic synchondrosis is found predominantly in athletes, gymnasts, and young soccer players.
- mechanical inguinal, pubic, or ischial pain increasing with Hip abduction
- limping (particularly in young children)
- no history of trauma
- afebrile
On clinical examination, there is tenderness on palpation of the pubic symphysis.
Radiography
Irregular and fragmented appearance of the ischiopubic synchondrosis, with a hypertrophic aspect.
Incidental radiographic changes are common in asymptomatic children, particularly around 8-10 years of age (fusion between the pubis and ischium), presenting as an irregular and fragmented appearance of the synchondrosis. These should not be mistaken for Van Neck-Odelberg disease.
Therefore, in the case of an incidental finding without pain, this should be considered a simple ossification variant rather than a true osteochondrosis.
MRI
T2: T2 hyperintensity centered on the ischiopubic synchondrosis
T1: iso- or hypointense on T1
Management
Offloading with rest and cessation of sports activity.
Analgesics and NSAIDs.