Observations on symptomatic medial malleolar ossification centers

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Radiology

Background:

• Medial malleolar ossification centers (MMOC) are common radiographic findings in pediatric ankles.
• Symptomatic MMOC can present as ankle pain, particularly in active children and adolescents.
• The clinical significance and management of symptomatic MMOC require further elucidation.

Purpose of the Study:

• To describe the clinical presentation and outcomes of symptomatic medial malleolar ossification centers (MMOC).
• To determine the incidence of MMOC in asymptomatic pediatric and adolescent populations.
• To evaluate the effectiveness of conservative management strategies for symptomatic MMOC.

Main Methods:

• Retrospective review of 11 cases with symptomatic MMOC.
• Analysis of ankle roentgenograms from two groups of asymptomatic patients (ages 6-12 and 13-17 years) to assess MMOC incidence.
• Documentation of treatment interventions and symptom resolution.

Main Results:

• Eleven patients presented with symptomatic MMOC, experiencing ankle pain.
• Reduced athletic activity led to symptom improvement in 6 out of 10 patients.
• Four patients required short-leg walking casts, with two experiencing symptom recurrence necessitating repeat casting.
• Incidence of MMOC was 20% in the younger asymptomatic group (6-12 years) and 4% in the older group (13-17 years).

Conclusions:

• Symptomatic medial malleolar ossification centers (MMOC) are a cause of ankle pain in pediatric and adolescent populations.
• Conservative management, including activity modification and casting, is effective in resolving symptoms associated with MMOC.
• Understanding the incidence of MMOC in asymptomatic individuals aids in differentiating between incidental findings and symptomatic presentations.