Trevor's disease of the distal radioulnar joint in two children with achondroplasia

Am J Med Genet A. 2020 May;182(5):1249-1254. doi: 10.1002/ajmg.a.61529. Epub 2020 Feb 29.

Abstract

Two children with achondroplasia who developed an abnormal bony outgrowth at the distal radioulnar joint (DRUJ), indistinguishable from an osteochondroma on histology, but the radiographic appearance, location, and asymmetry suggested the rare diagnosis of dysplasia epiphysealis hemimelica (DEH or "Trevor's disease"). One child experienced symptomatic relief with surgical excision and one was observed clinically due to lack of significant symptoms. These are the first presented cases of DEH in achondroplasia, both affecting the DRUJ. Due to the infrequency of DEH, more research is needed to better understand the potential connection to achondroplasia. For management, we suggest shared surgical decision making based on symptoms.

Keywords: Trevor's disease; achondroplasia; distal radioulnar joint; dysplasia epiphysealis hemimelica.

Publication types

  • Case Reports

MeSH terms

  • Achondroplasia / diagnostic imaging
  • Achondroplasia / genetics*
  • Achondroplasia / physiopathology
  • Achondroplasia / surgery
  • Bone Diseases, Developmental / diagnostic imaging
  • Bone Diseases, Developmental / genetics*
  • Bone Diseases, Developmental / physiopathology
  • Bone Diseases, Developmental / surgery
  • Child
  • Epiphyses / diagnostic imaging
  • Epiphyses / physiopathology
  • Epiphyses / surgery
  • Female
  • Femur / abnormalities*
  • Femur / diagnostic imaging
  • Femur / physiopathology
  • Femur / surgery
  • Humans
  • Male
  • Osteochondroma / diagnostic imaging
  • Osteochondroma / genetics*
  • Osteochondroma / physiopathology
  • Osteochondroma / surgery
  • Tibia / abnormalities*
  • Tibia / diagnostic imaging
  • Tibia / physiopathology
  • Tibia / surgery
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / physiopathology
  • Wrist Joint / surgery

Supplementary concepts

  • Dysplasia epiphysealis hemimelica