Multiple epiphyseal dysplasia in children: beware of overtreatment!

To determine the various musculoskeletal manifestations of multiple epiphyseal dysplasia in children, and the course of this disease in childhood.

Ten children were diagnosed and treated at the Children's Hospital of Eastern Ontario (CHEO) for multiple epiphyseal dysplasia, 1976-2001. We reviewed the clinical, pathological and radiographic records for these cases to determine cause of presentation and progress of the musculoskeletal pathology during the course of this disease in this age group.

Average age at time of first presentation was 6 years and 4 months (range 2 wk to 13 yr). Mean follow-up was 6 years and 2 months (range 1-144 mo). Only 2 children required surgery. Two children were diagnosed at birth; 2 were referred as cases of bilateral Legg-Calvé-Perthes disease. Two children presented with asymmetrical genu valgum; 1 with knee pain, genu valgum, loose bodies, and early degenerative joint disease of both knees; and 2 with limp.

Although multiple epiphyseal dysplasia is a disease of childhood, it is seldom severe enough to require operative intervention in the initial 2 decades of life.