Bilateral Trevor’s Disease of Ankle: A Rare Presentation and Treatment Consideration

Case Report | Volume 11 | Issue 3 | September-December 2025 | Page: 24-27 | Gaurav Kumar, Amitosh Mishra, Abhishek Verma, Anuj Rastogi

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.250

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 29/09/2025; Reviewed: 18/10/2025; Accepted: 13/11/2025; Published: 10/12/2025


Authors: Gaurav Kumar MS Ortho [1], Amitosh Mishra MS Ortho [2], Abhishek Verma MS Ortho [1], Anuj Rastogi MS Ortho [2]

[1] Department of Orthopaedics, Hind Institute of Medical Sciences, Sitapur, UP, India.
[2] Department of Orthopaedics, Integral Institute of Medical Sciences & Research, Lucknow, UP, India.

Address of Correspondence
Dr. Amitosh Mishra,
Department of Orthopaedics, Integral Institute of Medical Sciences & Research, Lucknow, UP, India.
E-mail: dramitoshmishra@gmail.com


Abstract

Trevor’s Disease, also referred to as Dysplasia epiphysealis hemimelica (DEH), is an uncommon skeletal developmental disorder which is characterized by an asymmetrical growth of the epiphyseal cartilage. A 5-year-old boy presented with bilateral painless swelling on the medial aspect of both feet for 3 years which had progressively increased in size. X-ray and magnetic resonance imaging (MRI) showed swelling from the inferomedial aspect of the talus. It was managed surgically by excision of the swelling. Histopathology revealed an osteochondroma of the talus arising from the epiphysis. Early diagnosis and treatment are necessary to prevent articular dysfunction of the tibiotalar and subtalar joints.
Keywords: Epiphyseal tumors, Ankle osteochondroma, Ankle swelling, Dysplasia epiphysealis hemimelica, Trevor’s disease


References

1. P. A. A. Struijs, G. M. M. J. Kerkhoffs, and P: P. Besselaar, “Treatment of Dysplasia Epiphysealis Hemimelica: A Systematic Review of Published. Reports and a Report of Seven Patients,”Journal of Foot and Ankle Surgery, vol. 51, no. 5. 620:626.
2. V. Merzoug, P. Wicard, J. Dubousset, and G. Kalifa: Bilateral dysplasia epipysealis hemimelica: Report of two cases,. Pediatric Radiology, vol. 32, no. 6, pp. 431-434. 2002,
3. R. S. Kuo, M. C. Bellemore, F. P. Monsell, K. Frawley, and K.Kozlowski: Dysplasia epiphysealis hemimelica: Clinical features and management,. Journal of Pediatric Orthopaedics. 4:543-548.
4. D. Trevor: “Tarso-epiphysial aclasis; a congenital error of epiphysial development,” The Journal of Bone and Joint Surgery. British Volume, vol. 32:204-213.
5. A. F. Mavrogenis, P. J. Papagelopoulos, and P: N. Soucacos, “Skeletal osteochondromas revisited,” Orthopedics, vol. 31, no. 10. 1018:2008.
6. Fairbank TJ (1956: Dysplasia epiphysealis hemimelica (tarsoepiphyseal acalasis). J Bone Joint Surg Br. 38:237-257.
7. Carlson DH, Wilkinson RH: Variability of unilateral epiphyseal dysplasia (dysplasia epiphysealis hemimelica). Radiology. 1979, 133:369-73.
8. Connor JM, Horan FT, Beighton P: Dysplasia epiphysialis hemimelica. A clinical and genetic study . J Bone Joint Surg Br. 1983, 65:350-4.
9. Kettelkamp DB, Campbell CJ, Bonfiglio M: Dysplasia epiphysealis hemimelica. A report of fifteen cases and a review of the literature. J Bone Joint Surg Am. 1966, 48:746-65.
10. Bhosale SK, Dholakia DB, Sheth BA, Srivastava SK: Dysplasia epiphysealis hemimelica of the talus: Two case reports. J Orthop Surg. 2005, 13:79-82.
11. Hensinger RN, Cowell HR, Ramsey PL, Leopold RG: Familial dysplasia epiphysealis hemimelica, associated with chondromas and osteochondromas. Report of a kindred with variable presentations. J Bone Joint Surg Am. 1974, 56:1513-6.
12. R. Cruz-Conde, S. Amaya, and P: Valdivia, “Dysplasia epiphysealis hemimelica,”. Journal of Pediatric Orthopaedics, vol. 4. 5:625-629.
13. A. F. Mavrogenis, P. J. Papagelopoulos, and P: N. Soucacos, “Skeletal osteochondromas revisited,” Orthopedics, vol. 31, no. 10. 1018:2008.
14. W.-J. Bahk, H.-Y. Lee, Y.-K. Kang, J.-M. Park, K.-A. Chun, and Y.-G. Chung: Dysplasia epiphysealis hemimelica: radiographic and magnetic resonance imaging features and clinical outcome of complete and incomplete resection,. Skeletal Radiology, vol. 39, no. 1, pp. 85-90. 2010,
15. S. B. Rao and D. R. Roy: Dysplasia epiphysealis hemimelica: upper limb involvement with associated osteochondroma,. Clinical Orthopaedics and Related Research, no. 307. pp.:103-109.
16. Shinozaki T, Ohfuchi T, Watanabe H, Aoki J, Fukuda T, Takagishi K: Dysplasia epiphysealis hemimelica of the proximal tibia showing epiphyseal osteochondroma in an adult. Clin Imaging. 1999, 23:168-71.
17. DeVine JH, Rooney RC, Carpenter C, Pitcher JD: Dysplasia epiphysealis hemimelica in an elderly patient . Am J Orthop (Belle Mead NJ. 1997, 26:223-5.
18. Arkader A, Friedman JE, Moroz L, Dormans JP (2007: Acetabular dysplasia with hip subluxation in Trevor’s disease of the hip. Clin Orthop Relat Res. 457:247-252.
19. Segal LS, Vrahas MS, Schwentker EP (1996: Dysplasia epiphysealis hemimelica of the sacroiliac joint: a case report. Clin Orthop Relat Res. 333:202-207.
20. Azouz EM, Slomic AM, Marton D, Rigault P, Finidori G: The variable manifestations of dysplasia epiphysealis hemimelica. Pediatr Radiol. 1985, 15:44-9.


How to Cite this Article:  Kumar G, Mishra A, Verma A, Rastogi A. Bilateral Trevor’s Disease of Ankle: A Rare Presentation and Treatment Consideration. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3):24-27.

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