Van Neck’s Disease-Fact or Fiction?

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VAN Neck1 in 1924 described two children who had swelling and demineralization of the ischiopubic synchondrosis with local pain and soft-tissue reaction. Since then, the term “Van Neck’s disease” (“ischiopubic osteochondrosis”) has been applied to the roentgen evidence of osseous swelling of the ischiopubic synchondrosis with or without other manifestations. This paper is presented to review the pertinent literature briefly, and to clarify the currently prevalent opinion that the roentgen findings of Van Neck’s disease are actually only normal developmental variations.

The development of the pubic bone begins in the fetus during the fifth or the sixth month, when the center of ossification is formed in the horizontal ramus at the edge of the obturator foramen.2 The ischium normally begins to ossify in the superior ramus in the fetus during the fifth month. As growth progresses, the cartilage between the ischial and the pubic rami is replaced by bone until fusion occurs. This area, called the “ischiopubic synchondrosis,” undergoes fusion relatively early in childhood, whereas in the acetabular region, synostosis does not occur until puberty.

Köhler2 believes that ischiopubic osteochondrosis is observed chiefly in children from nine years to 12 years of age. He attributes the vesicular appearance to a developmental disturbance at the site of fusion.

Both of Van Neck’s1 patients had pain and regional signs of inflammation. The histologic diagnosis based on the findings in the biopsy specimen of bone was osteochondritis. In both cases incision and drainage gave prompt relief of symptoms with somewhat slower regression of. . .



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