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Kitamura T, Yamazaki S, Kijima T, Takamori Y, Watanabe E. Multiple Epiphyseal Dysplasia With Knee Joint Locking Symptoms Caused by Intra-articular Loose Bodies. Cureus 2024; 16:e58906. [PMID: 38800255 PMCID: PMC11118780 DOI: 10.7759/cureus.58906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Multiple epiphyseal dysplasia (MED) is a congenital disease causing epiphyseal dysplasia in long bones. Herein, we report a case of a middle-aged man with bilateral knee joint locking symptoms who was diagnosed with multiple epiphyseal dysplasia caused by Matrilin-3 (MATN3) pathogenic variants and was successfully treated with arthroscopic loose body removal. A 48-year-old man has had bilateral knee pain since his twenties and underwent loose body removal of both knees in his thirties. He visited our hospital for worsening locking symptoms in both knees. Twenty years ago, his son had been diagnosed with suspected multiple epiphyseal dysplasia. Genetic and imaging testing confirmed his diagnosis of multiple epiphyseal dysplasia due to Matrilin-3 pathogenic variants. Arthroscopic loose body removal was performed, and the locking symptoms disappeared after surgery. Arthroscopic loose body removal was effective for the locking symptoms in a mild adult case of multiple epiphyseal dysplasias caused by Matrilin-3 pathogenic variants.
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Affiliation(s)
- Takaki Kitamura
- Department of Orthopaedic Surgery, Chiba University, Graduate School of Medicine, Chiba, JPN
| | - Shuji Yamazaki
- Department of Orthopaedic Surgery, Fuji Orthopaedic Hospital, Fuji, JPN
| | - Takehiro Kijima
- Department of Orthopaedics and Traumatology, Fuji Orthopaedic Hospital, Fuji, JPN
| | - Yasuyuki Takamori
- Department of Orthopaedic Surgery, Fuji Orthopaedic Hospital, Fuji, JPN
| | - Eiichiro Watanabe
- Department of Orthopaedic Surgery, Fuji Orthopaedic Hospital, Fuji, JPN
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Chen X, You M, Liao K, Zhang M, Wang L, Zhou K, Chen G, Li J. Quantitative Magnetic Resonance Imaging Had Greater Sensitivity in Diagnosing Chondral Lesions of the Knee: A Systematic Review and Meta-Analysis. Arthroscopy 2024:S0749-8063(24)00091-4. [PMID: 38336108 DOI: 10.1016/j.arthro.2024.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/21/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To investigate the accuracy and reliability of magnetic resonance imaging (MRI) in identifying and grading chondral lesions and explore the optimal imaging technique to image cartilage. METHOD A comprehensive search was conducted on Medline, Embase, and Cochrane Library. Eligible cohort studies published before August 2022 were included. The study reports used MRI to diagnose and grade cartilage lesions, with intraoperative findings as the reference standard. Summary estimates of diagnostic performance were obtained. The reliability of MRI interpretation was summarized. Subgroup analyses were performed based on assessed imaging techniques, field strength, and joint surface. RESULTS Forty-three trials and 3,706 patients were included in the systematic review. The overall area under curve for hierarchical summarized receiver operating characteristics was 0.91 (95% confidence interval [CI] 0.88-0.93). The pooled sensitivity for quantitative MRI, 3-dimensional MRI, and 2-dimensional MRI was 0.82 (95% CI 0.64-0.92), 0.79 (95% CI 0.74-0.83), and 0.63 (95% CI 0.51-0.73), respectively. The pooled sensitivity of 3 Tesla (3T), 1.5 Tesla (1.5T), and <1.5 Tesla MRI was 0.79 (95% CI 0.72-0.85), 0.67 (95% CI 0.60-0.74), and 0.55 (95% CI 0.39-0.71), respectively. There were differences in interobserver consistency across different studies. CONCLUSIONS In general, MRI had high specificity in discriminating normal cartilage, but its sensitivity for identifying chondral lesions is less optimal. Further analysis showed that quantitative MRI, 3D MRI, and 3T MRI demonstrate greater sensitivity compared with 2D MRI, 1.5T MRI, and <1.5 Tesla MRI. LEVEL OF EVIDENCE Level III, systematic review of Level II-III studies.
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Affiliation(s)
- Xi Chen
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mingke You
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Liao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Lingcheng Wang
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Zhou
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gang Chen
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jian Li
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Yoshida T, Kim WC, Oka Y, Nakase M, Nishida A, Wada H, Arai Y, Kubo T. Modyfied wedge osteotomy for osteoarthritis of elbow secondary to osteochondritis dissecans in adolecent with multiple epiphyseal dysplasia. A case report. J Orthop 2017; 14:515-519. [PMID: 28860685 PMCID: PMC5568871 DOI: 10.1016/j.jor.2017.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/06/2017] [Indexed: 11/30/2022] Open
Abstract
Multiple epiphyseal dysplasia (MED) may be complicated by osteochondritis dissecans (OCD), most commonly reported in the knee, but involvement of the elbow is very rare. Optimal treatment for MED-associated elbow OCD and treatment outcome have not been established. This report describes the case of an adolescent male patient with elbow OCD treated by arthroscopic drilling at a previous clinic. Progression of osteoarthritis and radial head subluxation were observed. Resection of the osteophytes and modified wedge osteotomy of the lateral condyle were then performed, and a favorable result was obtained by decompression and sufficient congruency of the radiohumeral joint.
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Affiliation(s)
- Takashi Yoshida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Wook-Cheol Kim
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshinobu Oka
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masashi Nakase
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Nishida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Wada
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Arai
- Department of Sports Para-Sports Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshikazu Kubo
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Koch JE, Mann G, Hetsroni I. Extensive Arthroscopic Chondroplasty for Cartilage Hyperplasia of the Femoral Condyle Causing Recurrent Knee Locking in a Patient With Multiple Epiphyseal Dysplasia. Arthrosc Tech 2016; 5:e229-34. [PMID: 27354941 PMCID: PMC4913047 DOI: 10.1016/j.eats.2015.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/18/2015] [Indexed: 02/03/2023] Open
Abstract
Multiple epiphyseal dysplasia is a genetically heterogeneous group of diseases causing altered enchondral ossification. It may affect the knee, among other joints, with variable clinical manifestations. In this report, we present a case of a young adult patient with multiple epiphyseal dysplasia, presenting recurrent catching and locking of the knee due to hyperplastic irregular cartilage. Although radiographs and magnetic resonance imaging of his knee were inconclusive with regard to the source of symptoms, arthroscopic examination revealed a flap of irregular and extensive hypertrophic cartilage of the medial femoral condyle that was causing catching during knee motions. This was treated by extensive arthroscopic resection of the hypertrophic cartilage with the knee held in a deep flexion position and symptoms resolved uneventfully. The case emphasizes the importance of a thorough arthroscopic examination when radiographs and magnetic resonance imaging may overlook the specific source for symptoms, and shows the potential for symptom resolution by arthroscopic intervention in these unusual circumstances.
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Affiliation(s)
- Jonathan E.J. Koch
- Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Address correspondence to Jonathan E.J. Koch, M.D., Department of Orthopedic Surgery, Meir Medical Center, Kfar Saba, Israel.Department of Orthopedic SurgeryMeir Medical CenterKfar SabaIsrael
| | - Gideon Mann
- Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iftach Hetsroni
- Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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