Abstract
Background:
Ischiopubic Synchondrosis (IPS) is the temporary cartilaginous joint between os ischii and os pubis which is present at birth and eventually undergoes complete pre-pubertal ossification. Unexplained or trauma-induced pain in the groin, lower limb, and/or buttock with or without positive clinical findings in the ischiopubic region poses a significant diagnostic challenge in the pre-pubertal age group.
“Osteochondrosis of ischiopubic synchondroses (IPS)” is also known by the eponym “Van Neck-Odelberg” disease. Paediatric patients presenting with unilateral pain in the groin and associated limp consist of differential diagnoses - such as trauma-induced stress fractures, infectious causes like osteomyelitis and tuberculosis, post-traumatic osteolysis, or any neoplastic process. A detailed clinical examination with corresponding imaging is paramount to arrive at a diagnosis.
Case presentation:
We present an 11-year-old, right limb dominant boy who was attended at casualty with an acute tenderness in the left groin and buttock as the only concerning symptom post playing a football game. After the routine clinical examination, the boy was sent for pelvic and hip radiographs, which revealed an expansile sclerotic lesion in the ischiopubic region on the left.
Conclusion:
Diagnosis of osteochondritis of ischopubic synchodroses or Van Neck-Odelberg disease is quite challenging as other conditions such as post- traumatic stress fractures, osteolysis, infective causes like osteomyelitis and tuberculosis, or any other neoplastic process in pre-pubertal-age group has to be ruled out. A thorough evaluation and detailed knowledge of this rare condition helps to avoid unnecessary investigations, anxiety among families, and unwarranted invasive procedures. Clinical symptoms must be present to call it an osteochondritis of IPS on radiographs as the unilateral delayed fusion of the ischiopubic synchondrosis is a physiologic process in asymptomatic cases.