About tarsomegaly

What is tarsomegaly?

Dysplasia epiphysealis hemimelica, also known as Trevor disease, is a rare skeletal developmental disorder of childhood. It is characterized by an overgrowth of cartilage on the ends (epiphyses) of the long bones of the arms and legs and the bones of the wrists (carpal bones) or the ankle (tarsal bones). The disorder may involve one epiphysis (localized) or multiple epiphyses. Most affected individuals develop a painless mass or swelling around the affected joint. Additional symptoms may develop in some cases. The exact cause of dysplasia epiphysealis hemimelica is unknown.

What are the symptoms for tarsomegaly?

The symptoms present in each child with DEH vary depending on the location and size of the cartilage mass. The most common is a painless mass or Swelling on one side of an affected joint, particularly the medial side. Pain usually occurs at a later stage of the disease.

Additional symptoms have been reported including Decreased range of motion of affected joints, joint deformity, limb length discrepancy, and muscle wasting in the affected area. Rarely, the joint may lock. Some children may limp due to damage of the involved joints of the lower limbs. If left untreated, the joint will develop degenerative arthritis.

What are the causes for tarsomegaly?

The cause of DEH is unknown. There is no evidence that hereditary factors play a role in the development of this disease. More research is necessary to determine the exact underlying cause(s) of this disorder. DEH is benign and there are no reports of malignant transformation of the cartilage abnormality.

What are the treatments for tarsomegaly?

The treatment of DEH is essentially surgical removal of the osteocartilaginous lesion, usually by a pediatric orthopedic surgeon. Some authors recommend conservative treatment in early asymptomatic lesions, and surgery when the lesion is painful and is associated with joint abnormalities. Others proposed early resection, even in asymptomatic children, in order to prevent later joint complications. During surgery, any damage of the pre-existing cartilage should be avoided. The presence in the MRI of a cleavage or separation between the mass and the normal cartilage may facilitate the removal of the lesion by the surgeon. Recurrence is unlikely, but has been reported. Some children with incomplete resections may do well and do not require additional surgery.

There are recent medical publications describing resection of DEH lesions by using arthroscopic surgery. Although experience with this technique is limited, it should be considered for the treatment of intra-articular lesions.

In some cases of DEH, other types of treatment may be necessary according to the location, size of the lesion and the duration of the disease.

What are the risk factors for tarsomegaly?

Tarsomegaly is induced mostly in dysplasia epiphysealis hemmeletica. "Dysplasia epiphysealis hemimelica (DEH), also known as Trevor disease, is an extremely rare, non-hereditary disease that is characterized by osteochondromas arising from the epiphyses.
This disorder is rare and is characterized by an asymmetrical limb deformity due to localized overgrowth of cartilage, histologically resembling osteochondroma. It is believed to affect the limb bud in early fetal life. The condition occurs mostly in the ankle or knee region and it is always confined to a single limb. This usually involves only the lower extremities and on the medial side of the epiphysis. It is named after researcher David Trevor.

1. The cause of DEH is unknown. There is no evidence that hereditary factors play a role in the development of this disease. More research is necessary to determine the exact underlying cause(s) of this disorder. DEH is benign, and there are no reports of malignant transformation of the cartilage abnormality.
2. Men and women are affected in a ratio of 3:1. This disease is more often seen in children rather than adults.
3. The treatment of DEH is essentially surgical removal of the osteocartilaginous lesion, usually by a pediatric orthopedic surgeon.
4. Some authors recommend conservative treatment in early asymptomatic lesions, and surgery when the lesion is painful and is associated with joint abnormalities.

Symptoms
Osteochondromas arising from the epiphyses
Conditions
Ankle or knee region and is always confined to a single limb
Drugs
Surgical removal of osteochondroma

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