Presence of Pseudoepiphyses in All the Metacarpal and Metatarsal Bones of a 9 Year-Old Girl: An Extremely Rare Case
American Journal of Pediatrics
Volume 3, Issue 4, July 2017, Pages: 18-22
Received: Jul. 16, 2017;
Accepted: Jul. 31, 2017;
Published: Aug. 24, 2017
Views 1682 Downloads 67
Juan Garces Garces, Image Department, Hospital Metropolitano, Quito, Ecuador
Maria Emilia Arteaga, Genetics Department, GyneMedic Institute, Mexico City, Mexico
Diana Granda Gonzalez, Pediatrics Department, Hospital Metropolitano, Quito, Ecuador
Presentation of a 9 year-old girl case. An X-ray of her left hand, requested by her paediatrician to evaluate her bone age, revealed pseudoepiphyses in the non-epiphyseal ends of the five metacarpal bones. For this reason, X-rays were taken of the opposing hand and of the feet, which revealed that they had the same pseudo-epiphyseal pattern. X-rays of the rest of her skeleton did not reveal any other pathology. A clinical evaluation performed by a Geneticist did not show any syndromic association. The conclusion is that this is an extremely rare case of an isolated bone variant.
Juan Garces Garces,
Maria Emilia Arteaga,
Diana Granda Gonzalez,
Presence of Pseudoepiphyses in All the Metacarpal and Metatarsal Bones of a 9 Year-Old Girl: An Extremely Rare Case, American Journal of Pediatrics.
Vol. 3, No. 4,
2017, pp. 18-22.
T. Laor, J. P. Clarke and H. Yin, “Development of the long bones in the hands and feet of Children: Radiographic and MR imaging correlation”, Pediatric Radiology, 2016, vol. 46(4), pp. 551-561.
M. C. Lee and S. M. Garn, “Pseudoepiphyses or notches in the non-epiphyseal end of the metacarpal bones in healthy children”, Anat Rec, 1967, vol. 159, pp. 263-272.
T. R. de Jong, W. B. W. H. Melenhorst and P. Houpt, “Complete PseudoepiphysesWith Associated Enhanced Growth In Hands and Feet: A Report of 2 Siblings. Case Report”, J Hand Surg Am, 2014, vol. 39 (3), pp. 488-492.
D. Limb and P. R. Loughenburg, “The prevalence of the pseudoepiphyses in the metacarpal of the growing hand”, The Journal of Hand Surgery, 2012, vol. 37 (7), pp. 678-381.
R. W. Haines, “The pseudoepiphyses of the first metacarpal of man”, J Anat, 1974, vol. 117 (1), pp. 145-158.
J. A. Ogden, T. M. Ganey, T. R. Light, R. J. Belsole and T. L. Greene, “Ossification and pseudoepiphyses formation in the ‘non-epiphyseal’ end of the bones of the hands and feet”, Skeletal Radiology, 1944, vol. 23, pp. 3-13.
V. E. Wood, J. D. Hannah and W. Stilson, “What happens to the double epiphyses end of the metacarpal bones in the hand”, J Hand Surg Am, 1994, vol. 19 (3), pp. 353-360.
E. Lachman, “Pseudo-epiphyses in hand and foot”, Am J Roentgenol, 1953, vol. 70, pp. 149-151.
E. Levine, “Notches in the non-epiphyseal ends of the metacarpals and phalanges in children of South African population”, Am J Phys Anthropol, 1972, vol. 36, p. 407.
R. Wagner, “Non-Endocrine Dwarfism and pseudoepiphyses”, Am J Dis Child, 1956, vol. 91, pp. 6-13.
G. Moses, C. Howard, J. Bar-Ziv, S. Dekeland M. Nyska, “’Epiphyseal Digenesis’ in Laurence-Moon-Biedl-Bardet Syndrome”, J PediatrOrthop, 1998, vol. 7, pp. 193-198.
G. Beluffi and S. Savasta, “Wolf-Hirschhorn syndrome: diagnosis using hand radiograph performed for bone age”, PediatrRadiol, 2010, vol. 40, p. 1580.
J. Pizones, A. Gomez-Rice, J. Pareja and J. Fernandez, “Proximal epiphyses of the second metatarsal: Normal Trail, Possible contribution to growth, and clinical implication”, Orthopedics, 2011, vol. 34 (11), pp. 741-747.
D. Resnick and G. Niwayama, “Diagnosis of bone and joint disorders”, 2nd ed., Saunders, Philadelphia.
K. Posener, E. Walker and G. Wedell, “Radiographic studies of metacarpal bones in children”, J Anat, 1939, vol. 74, pp. 76-79.
T. Nakashima and H. Furukawa, “A rare case of complete proximal epiphyses (so-called pseudoepiphyses) of metacarpal and metatarsal bones in the human”, Ann Anat, 1997, vol. 179 (6), pp. 549-551.
W. W. Greulich and S. I. Pyle, “Skeletal development of the hand and wrist”, 2nd ed., Stanford University Press. Stanford, Carolina, 1959.