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Avascular Necrosis and Related Disorders



Van Neck described a lesion with lucency and fragmentation of the ischiopubic synchondrosis as an osteochondritis. Clinical, radiologic, and pathologic observations has now regarded this as a very common, normal pattern of ossification. The pattern may be unilateral or bilateral and the closure of the synchondrosis usually takes place between the ages of 9 and 11 years. The irregular ossification of the synchondrosis which can be mistaken for a disease process is most apparent between the ages of 5 and 8 years. Differential diagnosis can be quite significant and includes a stress fracture, post-traumatic osteolysis, and infection. Increased diagnostic difficulty arises when bone-seeking radionuclides accumulate in the region of this normal process, therefore no follow-up should be taken of this clinically insignificant entity.


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