METAPHYSEAL DYSPLASIA, EPIPHYSEAL DYSPLASIA, DIAPHYSEAL DYSPLASIA, AND RELATED CONDITIONS

Abstract

MULTIPLE epiphyseal dysplasia, described by Barrington-Ward in 1912,¹has achieved recognition as a clear-cut clinical entity through the work of Fairbank.* It may masquerade under the title multiple osteochondritis, bilateral Legg-Perthes disease, Morquio's disease, stippled epiphyses, Kaufman's hyperplastic chondrodystrophy, or even cretinism. Earlier reports are reviewed (in German) by Jansen⁹and Ribbing.¹³ The disorder consists essentially of irregularity in form and structure of the developing epiphyses, which usually appear two to three years late. Multiple centers of ossification may develop at different times in the same epiphysis, but the extreme stippling of punctate epiphyseal dysplasia³does not occur. The affection is bilateral and nearly symmetrical. It progresses toward consolidation, so that successive roentgenograms demonstrate improvement with age. Epiphyseal union is generally little delayed. After puberty some abnormal- ity of epiphyseal shape or joint angulation may bear witness to the previous cartilaginous dysplasia. The bone in adult