Abstract
One-third of twins are monozygotic. Of monozygotic twins, 25% of them are mirror images. Mirror-imaging occurs when pathologic conditions are present on opposite sides of the body. This is the first case report of mirror-image identical twins with opposite hip pain that were found to have small cysts of the femoral head on opposite hips. Case presentation: 38 year-old mirror-image Asian female identical twins presented with hip pain on opposite sides. MRI demonstrated a 4 mm cyst of the anterior aspect of the left hip, the femoral head and neck junction, with a herniation pit on opposite sides. The right-handed twin had the cyst on the right hip, and the left-handed twin had the cyst on the left hip. Conclusion: Mirror-image pathology in mirror-image monozygotic twins suggests possible cytogenetic factors involved in the etiology of various medical problems. If an identical twin presents with a medical problem, it may be recommended to perform a medical diagnostic work-up on the other twin.
Highlights
Twin studies historically have aided in understanding how genetic and environmental factors affect various pathologies [1,2]
Mirror-image pathology in mirror-image monozygotic twins suggests possible cytogenetic factors involved in the etiology of various medical problems
38 year-old mirror-image Asian female identical twins presented with hip pain on opposite sides 3 weeks apart
Summary
Mirror-image pathology in mirror-image monozygotic twins suggests possible cytogenetic factors involved in the etiology of various medical problems and can help elucidate the mechanism of pathologic conditions, such as cleft palates and lips. There is concordance for medical conditions in identical twins. If an identical twin presents with a medical problem, it may be recommended to perform a medical diagnostic work-up on the other twin. Written informed consent was obtained from the parents of our patients for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal
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