Presentation
To the best of our knowledge, no other similarly affected family has been presented in the literature. [ncbi.nlm.nih.gov]
Entire Body System
- Fatigue
The disease has symptom fatigue, has symptom joint pain. polyepiphyseal dysplasia Fairbank's disease MED edit English multiple epiphyseal dysplasia An osteochondrodysplasia that has material basis in defective cartilage mineralization into bone which [wikidata.org]
The disease has_symptom fatigue, has_symptom joint pain. [bioportal.bioontology.org]
The progression of the disease also affects muscles, with increasing atrophy, resulting in muscle fatigue and pain. Muscular atrophy has not been reported earlier in cases with COL9A2 mutations. [ncbi.nlm.nih.gov]
We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 13, 2019 [patientslikeme.com]
- Hunting
Hunt DD, Ponseti IV, Pedrini-Mille A, Pedrini V. Multiple epiphyseal dysplasia in two siblings. Histological and biochemical analyses of epiphyseal plate cartilage in one. J Bone Joint Surg Am. 1967 Dec. 49(8):1611-27. [Medline]. [emedicine.medscape.com]
- Hyperthermia
There was no effusion, no hyperthermia, but slight synovial swelling detectable on either side. Both femorotibial joints were medially, laterally and anteriorly instable. [bmcmusculoskeletdisord.biomedcentral.com]
Musculoskeletal
- Flexion Contracture
There may be a delay in walking or flexion contractures of the knees or elbows. However, symptoms may also develop as late as adulthood. These patients have somewhat short stature, with height ranging from 145 to 170 cm (57 to 67 in.). [posna.org]
Abnormalities of the femoral condyle and intercondylar notch have been shown to be causes of ACL damage in patients with degenerative knee arthritis, and in these patients arthroscopic notchplasty was successful in improving flexion contracture, pain [jmedicalcasereports.com]
In three of four cases there was a bilateral extension contracture of a MCP joint. The following disorders occurred in two cases: flexion contracture in both elbow joints, mild scoliosis, mild dysplastic changes of the vertebral bodies. [bmcmusculoskeletdisord.biomedcentral.com]
Neurologic
- Waddling Gait
Patients with MED and a waddling gait but minimal radiographic hip involvement should be evaluated for a primary myopathy and a mutation in type IX collagen. [ncbi.nlm.nih.gov]
Clinical description EDM1 (see this term) is clinically the best characterized form of EMD and is marked by a waddling gait and pain at onset, and moderate short stature. The main complication is early arthrosis of the hip. [orpha.net]
Joint pain, joint deformity, waddling gait, and short stature are the main clinical signs and symptoms. [uniprot.org]
Physical exam is notable for a valgus left knee and a waddling gait. Radiographs of the pelvis, knees, and left hand are provided in figures A-C. Genetic testing reveals a mutation of the cartilage oligomeric matrix protein(COMP). [orthobullets.com]
Waddling gait Signs: Joint deformity (eg. valgus knee). Early OA. Joint contractures. Hyperextensible fingers Minor (investigative) findings On x-ray: Instability of upper C-spine. Bilateral epipyseal defects on pelvic film. [slideshare.net]
- Stiff Gait
MED affects both sexes, and onset of symptoms usually begins early in or before the third decade of life [ 3 ], although in some forms patients experience joint pain, stiffness, gait abnormalities and retarded growth in early childhood [ 4 ]. [jmedicalcasereports.com]
Workup
[…] survey helps to differentiate between these two disease processes because LCP does not demonstrate the deformities about the knee and other joints typically seen with MED. 18 Acetabular changes associated with MED are typically found at the initial workup [journals.lww.com]
Treatment
Treatment of the hip deformity in multiple epiphyseal dysplasia is a challenge for orthopedic surgeons.We reviewed the clinical features and treatment options of hip joints affected by multiple epiphyseal dysplasia in 6 young patients (4 boys and 2 girls [ncbi.nlm.nih.gov]
Management and treatment Current treatments involve mainly physiotherapy and orthopedic care. Hip replacement is frequently required, but the age at intervention is variable. [orpha.net]
Multiple epiphyseal dysplasia DIAGNOSIS AND TREATMENT The majority of individuals are diagnosed during childhood; however, some mild cases may not be diagnosed until adulthood. [muhealth.org]
Prognosis
Molecular diagnosis is important for accurate prognosis and genetic counselling. [ncbi.nlm.nih.gov]
Short stunted metacarpals and metatarsals Treatment Non-surgical: NSAIDs, Hydrotherapy Surgical: Corrective osteotomy, hemiepiphysiodesis ,total hip arthroplasty, others as needed (hand, elbow, etc) Prognosis A lifetime condition, that is not self-limiting [slideshare.net]
Coverage of each disorder includes more details on treatment and prognosis. [books.google.com]
Etiology
Abstract Seven patients (10 hips), five with multiple epiphyseal dysplasia and two with spondyloepiphyseal dysplasia, were studied as to the etiology of a significant change in their baseline symptoms. [ncbi.nlm.nih.gov]
Etiology EDM1 is transmitted in an autosomal dominant manner and is caused by mutations in the gene ( COMP ; 19p13.1) encoding the cartilage oligomeric matrix protein. [orpha.net]
The exact etiology of MED remains unclear. [emedicine.medscape.com]
Unger S, Hecht JT (2001) Pseudoachondroplasia and multiple epiphyseal dysplasia: new etiologic developments. Am J Med Genet 106:244–260 Google Scholar 6. Lachman R, Sillence D, Rimoin D, et al (1981) Diastrophic dysplasia: the death of a variant. [doi.org]
Epidemiology
Summary Epidemiology The average prevalence is estimated at around 1/20,000. Clinical description EDM1 (see this term) is clinically the best characterized form of EMD and is marked by a waddling gait and pain at onset, and moderate short stature. [orpha.net]
Introduction A form of dwarfism characterized by irregular, delayed ossification at multiple epiphyses spectrum of disorders with a spectrum of phenotypes Epidemiology prevalence approximately 1:10000 presents between age 5-14 years of age location caused [orthobullets.com]
Epidemiology: Clinical Findings: Patients typically present later in childhood with joint pain in the lower extremities, decreased range of motion, gait disturbance, or angular deformities of the knees, such as genu varum or valgum. [posna.org]
Epidemiology of osteochondrodysplasias: changing trends due to advances in prenatal diagnosis. Am J Med Genet 1996;61:49-58. Bonafe L, Cormier-Daire V, Hall C, Lachman R, Mortier G, Mundlos S, et al. [archivesofrheumatology.org]
Congenital generalised bone dysplasias: a clinical, radiological, and epidemiological survey. J Med Genet. 1989; 26(1):37-44. Wynne-Davies R, Gormley J. The prevalence of skeletal dysplasias. [healio.com]
Pathophysiology
There is a mild version (‘ribbing’) and a more typical, severe, form (‘Fairbanks’) Pathophysiology Irregular, delayed, ossification of multiple epiphyses. A defect in COMP (cartilege, oligomeric matrix protein) causes the most common form. [slideshare.net]
Pathophysiology delay of epiphyseal endochondral ossification lack of osseous support yields secondary articular cartilage deformity most commonly affects proximal femur and proximal humerus Genetics autosomal dominant is most common mutation in COMP [orthobullets.com]
However, some causative genes resulting in maturational delay in the epiphysis of the bone have been previously reported.( 6 ) Conservative treatment methods are applied as the genetic mechanisms play a role in the pathophysiology. [archivesofrheumatology.org]
Pathophysiology Cartilage oligomeric matrix protein (COMP) and matrilin-3 (MATN3) are thought to bridge extracellular matrix proteins. Collagen IX is important for the adhesive properties of cartilage. [emedicine.medscape.com]
Prevention
Mutations in the SLC26A2 gene alter the structure of developing cartilage, preventing bones from forming properly and resulting in the skeletal problems characteristic of recessive multiple epiphyseal dysplasia. [wikidoc.org]
[…] spectrum of skeletal disorders caused by mutations in the gene, which encodes a protein that is essential for the normal development of cartilage and its conversion to bone. [3] Mutations in the SLC26A2 gene alter the structure of developing cartilage, preventing [ipfs.io]
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Mutations in the COMP or MATN3 gene prevent the release of the proteins produced from these genes into the spaces between the chondrocytes. [ghr.nlm.nih.gov]
There is no current treatment to prevent worsening or change the course of Multiple Epiphyseal Dysplasia. Ultimately, there is a future potential for genetic intervention. [congenitalhand.wustl.edu]