Biplanar EOS screening in children with hereditary multiple osteochondromas: a feasible screening method?

Area of Science:

• Pediatric Orthopedics
• Medical Imaging Technology
• Skeletal Dysplasias

Background:

• Children with Hereditary Multiple Osteochondromas (HMO) require regular screening for dysplasia and osteochondromas.
• Early detection of these conditions is crucial for timely surgical intervention.
• EOS biplanar imaging offers low-radiation assessment of weight-bearing malalignment.

Purpose of the Study:

• To evaluate EOS imaging as a screening tool for osteochondromas in HMO children.
• To assess EOS's ability to detect frontal plane malalignment in the lower extremities of HMO patients.
• To compare EOS findings with conventional radiography for accuracy and reproducibility.

Main Methods:

• EOS biplanar imaging and conventional whole-leg radiographs were used to assess osteochondromas and frontal plane malalignment in ten HMO children.
• Standardized measurements were applied to hip, knee, and ankle joints for malalignment assessment.
• Patient-reported experience measures (PREM) were collected, and observer reproducibility was evaluated.

Main Results:

• EOS identified significantly more lower limb osteochondromas compared to conventional radiographs.
• Frontal plane malalignment measurements showed minimal systematic bias between EOS and conventional radiography.
• Intra-observer agreement was excellent for both modalities (CV_EOS=1%; CV_radiographs=2%), and EOS was well-tolerated.

Conclusions:

• EOS biplanar imaging is a well-tolerated and feasible alternative for screening HMO patients.
• It offers reduced radiation exposure compared to conventional radiography.
• EOS demonstrates potential for improved detection of lower limb osteochondromas in HMO children.