Authors: Muhammad Iqbal , Muhammad Naeem , Muhammad Babar Imran , Muhammad Shahzad Afzal , Muhammad Saeed Akhtar

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Article Info

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Abstract

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Background: Ischio-pubic Osteochondritis / Van Neck-Odelberg disease, is characterized by an atypical ossification pattern of the ischio-pubic synchondrosis. Radiologically it may mimic stress fracture, neoplasm, osteomyelitis, or posttraumatic osteolysis. 99mTc-MDP bone scintigraphy with SPECT/CT is one of the effective tools for its diagnosis. Case presentation: A male patient, 11 years of age visited nuclear medicine department of our hospital complaining of pain in the right hip with no history of any fever, trauma or fall. There were no clinical signs of inflammation or any swelling. X-ray showed lytic lesion in the ischio-pubic ramus with area of lucencies. A 99mTc-methylene diphosphonate (99mTc-MDP) bone scan showed focal area of increased uptake in the right inferior ischio-pubic ramus. SPECT/CT hybrid imaging showed areas of demineralization at the edges of ischio-pubic synchondrosis with areas of sclerosis, making a diagnosis of Ischio-pubic osteochondritis / van Neck-Odelberg disease / Synchondrosis ischio-pubic syndrome (SIS). Patient was later treated with anti-inflammatory drugs and steroids. Conclusion: Ischio-pubic Osteochondritis is one of the common differential diagnosis in children presenting with pain in the groin, hip or gluteal region and limping gait. Ample awareness of this ailment is necessary for early diagnosis and proper management, to alleviate the suffering of child.

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Keywords: 99mTc-MDP bone scintigraphy, SPECT/CT, Ischio-pubic Osteochondritis, Van Neck-Odelberg disease, Case report, green

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