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    Go to the top of the page   ID: 20030617204913 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Complicated van Neck's Disease
    Dirk Schaper. Complicated van Neck's Disease. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030617204913


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Kinderchirurgie Barbara-Krankenhaus Halle/S.)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Pelvis-Bones  

     
     Pediatric Radiology CasesMost likely etiology:

    other  

     
     Pediatric Radiology CasesHistory:

    8 year-old boy with pollakisuria, leucocyturia, bacteriuria and febrile temperatures. First, an antibiotic therapy was begun, but without improvement and a new increase in temperature, the patient was admitted to the hospital. Palpitory pain in the right lower quadrant and near the pubic bone, pain on percussion in the kidney, urine findings were normal. Thoracic x-ray was normal, sinuses normal, lumbar puncture normal, pelvic overview showed a spherical enlargement on the lower pubic ramus.
    In the MRIs which the patient brought from an outside clinic, osteomyelitis of the left pelvic ramus was suspected (not sure, since the parents declined contrast media).  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Passing intrasossary vascularization defect, which causes an aseptic bone necrosis.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Pelvic overview with expansion in the transition of ossic ischeal ramus to the inferior ossic pubic ramus.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Spotfilm

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Osteomyelitis, neoplasm  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Under the assumption of a bone inflammation in van Neck's disease, the antibiotic treatment is continued. The patient's fever lowered and quick disappearance of symptoms.

    A further scintigraphy could not confirm an inflammatory change, in contrast to MRI.

    Six months after treatment, the patient is still clinically healthy.  

     
     Pediatric Radiology CasesComments of the author about the case:

    This case was problematic on the whole. Aside from the typical findings of a van Neck's disease, clinical symptoms were in the foreground and almost unremarkable inflammatory lab values. Further imaging techniques could bring us information, more differential diagnoses were made. If the inflammation really was due to a pubic bone osteomyelitis can not be confirmed nor denied.
    Because of the undoubting radiological findings, we did not perform a biopsy.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Petje,G., radler,C., Kriegs-Au,G., Ganger,G., Grill,F.
    Aseptische Knochennekrosen im Kindesalter
    Orthopäde 2002 31:1027-1038  

     
     Pediatric Radiology CasesKeywords:

    aseptic bone necrosis, van Neck, complicated van Neck's disease, pollakisuria, leucocyturia, bacteriuria, fever, Van Neck-Odelberg disease, Van Neck-Odelberg syndrome, juvenile osteochondrosis, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Complicated van Neck's Disease. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030617204913  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Pelvis-Bones
    or in the region: Pelvis
    or in the tissue/organ: Bones
    or with the etiology: other
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     
    Complicated van Neck's Disease
    Dirk Schaper. Complicated van Neck's Disease. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030617204913


     

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    Complicated van Neck's Disease
    Other cases by these authors:

    Search Dirk Schaper in Medline Dirk Schaper (43)   

    Complicated van Neck's Disease  
     
    Complicated van Neck's Disease
    Dirk Schaper. Complicated van Neck's Disease. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030617204913


     

    Which diagnosis have other collegues guessed?


    • Ewing sarcoma
      Votes: 3 (23 %)


    • Osteomyelitis
      Votes: 4 (30 %)


    • Aseptic bone necrosis (van Neck)
      Votes: 5 (38 %)


    • Chrondroma
      Votes: 0 (0 %)


    • Osteosarcoma
      Votes: 1 (7 %)



        Total answers: 13

     
    Complicated van Neck's Disease
    Dirk Schaper. Complicated van Neck's Disease. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030617204913


     

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    Complicated van Neck's Disease
    Dirk Schaper. Complicated van Neck's Disease. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030617204913


     




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