title: Avascular necrosis of distal tibial epiphysis: report of two cases.
abstract: The authors present two cases of necrosis of the distal tibial epiphysis without evidence of trauma in either of the patients. One patient after a long follow-up showed a Charcot arthropathy. In contrast, the second patient recovered distal epiphysis ad integrum. Close follow-up and ankle protection with an orthosis may be necessary to spare the joint and prevent significant damage. The authors highlight the difficulty in diagnosing these special cases in which pain, a common finding in orthopaedics, is not present.
  
  
  METHODS
  IV.
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, Hospital Clínico Universitario, Valencia, Spain. jose.gasco@uv.es
authors.forename: José
authors.initials: J
authors.lastname: Gascó
authors.forename: Pedro
authors.initials: P
authors.lastname: González-Herranz
authors.forename: Mari-Fé
authors.initials: MF
authors.lastname: Minguez
authors.forename: Raúl
authors.initials: R
authors.lastname: Gil-Albarova
mesh_terms: D001177:Arthropathy, Neurogenic / Q000150:complications; D002675:Child, Preschool; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010020:Osteonecrosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology*