Distal Tibial Epiphysitis

NewsBot · Dec 16, 2014

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From Podiatry Today:
Diagnosing And Treating Distal Tibia Epiphysitis

NewsBot · Dec 16, 2014

Bilateral osteochondrosis of the distal tibial epiphysis: a case report.
Turati, Marco; Afonso, David; Salazard, Bruno; Maillet Declerck, Marie; Bigoni, Marco; Glard, Yann
Journal of Pediatric Orthopaedics B: December 12, 2014

Osteochondrosis is a developmental disease characterized by an alteration of endochondral ossification. Genetic causes, repetitive mechanical stresses, vascular abnormalities, hormonal imbalances, and interruption of the blood supply to the epiphyseal cartilage are all described causes of osteochondrosis and the etiology is probably multifactorial. Osteochondrosis can occur in different apophysis and epiphysis in all immature skeletons. Distal tibial epiphysis is rarely involved and most of the time unilaterally. We report on an 11-year-old female with bilateral osteochondrosis on distal tibial epiphysis. Only one other similar case has been described in the literature to date.
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NewsBot · Sep 3, 2016

Traction apophysitis of the medial malleolus.
Nema SK, Balaji G, Pasupathy P, Ravi N.
Clin Transl Orthop 2016;1:123-5 (full text)

Traction apophysitis of the accessory ossification center of the medial malleolus is infrequently reported. Traction apophysitis of both the accessory ossification centers of medial malleoli is very rare. This entity is also reported as osteochondrosis of medial malleolus in literature. We present a case of traction apophysitis of accessory ossification centers of both the medial malleoli in an 11-year-old boy of Indian origin, who presented with pain and swelling over both the ankle with plano-valgus deformity of feet. His imaging revealed fragmented accessory ossification center of medial malleoli on both the sides. He was treated non-operatively and followed through one year to see the eventual fate.
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NewsBot · Aug 29, 2017

Osteochondrosis of the medial malleolar epiphysis: A case report and review of the literature
Marco Turati et al
2017Volume 39, Pages 176–180

Highlights
•Presentation and management of medial malleolar osteochondrosis based on our
•experience and a complete literature review.
•All ossification centres are predisposed to develop osteochondrosis: we report a rare case of this painful condition.
•The first review of all described cases of medial malleolar osteochondrosis.
•In a pediatric ankle pain medial malleolar osteochondrosis should be considered in the differential diagnosis.
•A complete clinical and radiological description of a rare case of medial malleolar osteochondrosis.
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Introduction
Osteochondrosis is characterized by a disturbance of enchondral ossification in skeletally immature patients and should be investigated in children having a history of persistent foot and ankle pain. Involvement of the medial malleolar epiphysis is rarely reported.

Presentation of case
We describe the case of a sporty 12-year-old male with osteochondrosis of the left medial malleolar epiphysis treated with a conservative management.

Discussion
Calcanear, navicular and metatarsal apophysis are the most common locations for osteochondrosis in ankle and foot. Anyway other osteochondrosis should be excluded. Medial malleolar osteochondrosis is occasionally described. We performed a review of the relevant literature and we summarized clinical aspects, radiological characteristics and reported management of this painful and probably underestimated condition.

Conclusion
Medial malleolar osteochondrosis is a rare but well recognized condition. Only seven cases are described in literature.
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NewsBot · Feb 26, 2020

Painful Medial Ankle in a Young Dancer: A Case Report of a Symptomatic Secondary Ossification Center of the Medial Malleolus
Zhang, Mandy1; Wong, Yue Shuen2
Journal of Dance Medicine & Science, Volume 24, Number 1, March 2020, pp. 44-46(3)

An osseous fragment at the distal tip of the medial malleolus in a skeletally immature individual may represent a secondary ossification center and should not always be interpreted as a fracture. In this case study of a young dance student presenting with bilateral medial ankle pain, we postulated that hindfoot valgus, in combination with extreme loads placed on the foot during ballet training, increased stresses at the medial malleolus and accessory physis. Our patient was treated conservatively for symptomatic secondary ossification of medial malleolus and she returned to dance class at 6 months.
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