Regresar

The “Glacier Crevice” Sign, from Image to Diagnosis

Abstract:

A6-year-old obese girl presented with a 3-year history of hip pain, mainly after prolonged walking, and gait disturbance. Her body mass index was+ 3.39 SDS and clinical examination showed no major dysmorphic features, with mild genu valgum and flexible flat feet as the only skeletal pathologic findings. Hip radiograph showed bilateral femoral head dysplasia (Figure 1, A). Left hand and wrist radiograph showed irregularly shaped carpal bones, mainly capitate,(Figure 1, B), with sharpening also found in tarsal bones. Radiologic study revealed irregular epiphyses with major impairment of the knees and presence of the “glacier crevice” sign in distal femoral epiphyses (Figure 1, C), pathognomonic finding from deffective ossification in the epiphyses of developing bones. Although the height of the patient’s father (177 cm) and phenotype were normal, her mother exhibited a rhizomelic disproportionate growth (height …