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
child - intermittent claudication - osteochondrosis
