title: Dysplasia epiphysealis hemimelica: a report of four cases.
abstract: Dysplasia epiphysealis hemimelica (DEH), also known as Trevor's disease, is a rare congenital skeletal developmental disorder in childhood. It is characterized by an asymmetric osteocartilaginous overgrowth arising from epiphyses or epiphyseal equivalents. Lesions have hemimelic topography, usually occur in the lower limbs, most commonly in the ankle and the knee and affect either the medial or lateral part of one epiphysis.
  
  
  OBJECTIVE
  The purpose of this study is to describe the imaging features of DEH by reporting four cases.
  
  
  METHODS
  We present four cases of DEH in one female and three males aged between 7 and 15 years. Lower limb is involved in all cases and patients suffer from pain, limited function and deformity. Radiographs and CT findings were reviewed. All patients were treated by surgical excision.
  
  
  RESULTS
  Plain X-ray revealed in all cases an irregular ossification arising from the affected epiphysis. The CT scan revealed an irregular fragmented osteocartilaginous mass involved from the epiphysis, with enlargement of epiphyses and intra-articular extension.
  
  
  CONCLUSIONS
  The early diagnosis and treatment of DEH is necessary in preventing articular function, CT assists in defining the anatomic relationship between the mass and its parent epiphysis and in evaluating the condition of the articular cartilage and soft tissue. The distinct clinical and radiographic features should enable to differentiate the osteochondroma and the DHE.
authors.affiliation: Department of Pediatric Radiology, Children Hospital, Tunis, Tunisia. khomsiwiem@yahoo.fr
authors.forename: W
authors.initials: W
authors.lastname: Douira-Khomsi
authors.forename: H
authors.initials: H
authors.lastname: Louati
authors.forename: Y
authors.initials: Y
authors.lastname: Mormech
authors.forename: W
authors.initials: W
authors.lastname: Saied
authors.forename: S
authors.initials: S
authors.lastname: Bouchoucha
authors.forename: M
authors.initials: M
authors.lastname: Smida
authors.forename: M
authors.initials: M
authors.lastname: Ben Ghachem
authors.forename: A
authors.initials: A
authors.lastname: Hammou
authors.forename: I
authors.initials: I
authors.lastname: Bellagha
mesh_terms: D000293:Adolescent; D000842:Ankle / Q000000981:diagnostic imaging; D001848:Bone Diseases, Developmental / Q000000981:diagnostic imaging; D002648:Child; D004838:Epiphyses / Q000000981:diagnostic imaging; D005260:Female; D005269:Femur / Q000002:abnormalities / Q000000981:diagnostic imaging; D005528:Foot / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D013977:Tibia / Q000002:abnormalities / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed