Hamabe Fumiko, Edo Hiromi, Yamashita Taro, Matsumoto Hiroshi, Tamada Soichiro, Sumi Koji, Shinmoto Hiroshi
Department of Radiology, National Defense Medical College, Saitama, Japan.
Department of Orthopedic Surgery, National Defense Medical College, Saitama, Japan.
BJR Case Rep. 2020 Nov 4;7(2):20200155. doi: 10.1259/bjrcr.20200155. eCollection 2021 Apr 1.
Metatropic dysplasia (MD) is a rare skeletal disorder characterized by short stature due to epiphyseal cartilage and growth plate abnormalities. The severity of MD varies from mild to lethal. This disorder is caused by mutations in the ) that encodes calcium-permeable, nonselective cation channels. A 33-year-old female presented at our hospital with a history of worsening knee pain diagnosed at the previous institution as a case of osteoarthritis. Radiographs of the knee showed epiphyseal irregularity without joint space narrowing. On MRI, fat-suppressed proton density-weighted imaging revealed thickened articular cartilage with a smooth surface and an abnormal signal intensity of the subchondral bone; weighted imaging demonstrated irregularity of the epiphysis. These findings and the familial history (both her children had mutations) led to the suspicion that her condition could be due to mosaicism for mutation. To the best of our knowledge, this is the first report of MRI findings focusing on articular cartilage thickening in a patient with mild MD. Bone dysplasia including MD should be considered in young patients with articular cartilage thickening and subchondral bone irregularities on MRI.
变行性发育不良(MD)是一种罕见的骨骼疾病,其特征是由于骨骺软骨和生长板异常导致身材矮小。MD的严重程度从轻度到致命不等。这种疾病是由编码钙通透性非选择性阳离子通道的基因发生突变引起的。一名33岁女性因膝关节疼痛加重前来我院就诊,她曾在之前的机构被诊断为骨关节炎。膝关节X线片显示骨骺不规则,但关节间隙无变窄。在MRI上,脂肪抑制质子密度加权成像显示关节软骨增厚,表面光滑,软骨下骨信号强度异常;T2加权成像显示骨骺不规则。这些发现以及家族史(她的两个孩子都有该基因突变)导致怀疑她的病情可能是由于该基因突变的嵌合体所致。据我们所知,这是第一份聚焦于轻度MD患者关节软骨增厚的MRI表现的报告。对于MRI显示关节软骨增厚和软骨下骨不规则的年轻患者,应考虑包括MD在内的骨发育不良。