Bilateral osteochondroses of the accessory ossification centre of the medial malleolus: A rare entity

Abstract

We are reporting a rare case of a painful accessory ossification center of the bilateral medial malleoli in a 9 years old girl. Patient was not involved in any sport activity. There was no local foot deformity and limb malalignment. The patient was treated conservatively. There was complete clinical and radiographic healing of the medial malleolus eight months after the first presentation. Osteochondrosis of the accessory ossification center of medial malleolus is generally unilateral and bilateral involvement is very rare. There are various differential diagnosis for this pathological condition with similar clinical features and presentation in this age group. We ruled out the uncommon pathological conditions causing chronic pain in the medial malleolus during this period of skeletal growth. We consider this painful condition to be classified as a bilateral osteochondroses of the accessory ossification center of the medial malleolus. Osteochondrosis of the accessory ossification center of the bilateral medial malleolus is a rare entity. Due to rarity of disease and common presentation similar to other disease this is commonly misdiagnosed or missed in clinical practice. Osteochondrosis is characterized by a disturbance of endochondral ossification in skeletally immature patients and should be investigated in children having a history of persistent foot and ankle pain. An increased clinical attention to this painful condition could lead to improved diagnosis and treatment among the paediatric age group.