A Lumpy-Bumpy Painful Ankle - Trevor Disease of the Ankle in a 9-year-old

Dysplasia epiphysealis hemimelica, also known as Trevor disease, is a rare skeletal development disorder of childhood, characterized by asymmetric growth of the epiphyseal cartilage in childhood. The disease can be locally aggressive at the ankle, and can result in deformity or instability. We present a case of Trevor disease involving the lateral aspect of distal tibia and talus in a 9-year-old patient, and of highlight its clinical and radiological presentation, treatment, and outcomes.

A 9-year-old male presented with a painful swelling over the lateral aspect of the dorsum of right ankle and foot swelling for the past 1.5 years. Radiographs and computed tomography scan revealed exostoses arising from the lateral distal tibial epiphysis and talar dome. Skeletal survey revealed cartilaginous exostoses in distal femoral epiphyses, confirming the diagnosis. Wide resection was done, and the patients were asymptomatic and recurrence-free at 8 months follow-up.

Trevor disease around the ankle can have an aggressive course. Prompt recognition and timely surgical excision can prevent morbidity, instability, and deformity.