COMBINED METAPHYSEAL AND EPIPHYSEAL DYSOSTOSIS

REPORT OF TWO CASES-ONE, IN WHICH METAPHYSEAL CHANGES PREDOMINATE, AND A SECOND ONE, IN WHICH EPIPHYSEAL CHANGES ARE MORE MARKED

¹ Pediatric Institute of the Medical School, X-Ray Department, Kopernika 21, Krakow, Poland
² From the Pediatric Clinic, Medical School, Poznan, Poland; Director, T. Rafinski, M.D., and the Pediatric Clinic, Medical School, Wroclaw, Poland

Two cases of combined metaphyseal and epiphyseal dysostosis are reported.

Case I, a boy, 8 years, 9 months of age had disturbance of growth and ossification in the metaphyses and epiphyses. The metaphyses and the epiphyses were affected in different degrees in different bones, but the metaphyseal changes generally predominated. The vertebral bodies were flattened above the 12th thoracic segment. The metaphyseal dysostosis was most severe at the proximal ends of the humeri, both ends of the tibiae, and distal ends of radii and ulnae. The epiphyseal dysostosis was most severe at the proximal ends of the femora and proximal ends of the humeri.

This case is difficult to classify. Currently, it should be considered an example of dysostosis meta-epiphysealis.

Case II, a female, 12 years of age, is an example of epi-metaphyseal dysostosis. Roentgenograms showed disturbances of ossification and growth in the epiphyses as well as metaphyses. The bones of the hips and shoulders were most affected. Only slight changes were present at the other epiphyses and metaphyses. This case was mistakenly called dysplasia epiphysealis multiplex at the age of 3 years. The followup studies at the age of 12 years showed marked change with advancing age.

The importance of caution in the diagnosis of skeletal dysplasias during the first few years of life is emphasized.

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