Bone Scan Meyer Dysplasia
This is a 2 year and 5 months old boy (JRP) with limping in the left leg. It was raised the suspicion of Perthes disease. An X-ray demonstrated a possible late femoral head ossification in the left hip. A 3 phase bone scan was requested showing symmetric vascular hip activity. In the delay osteoblastic phase, paralell anterior and posterior collimator depicts normal images. Especially with pinhole collimator, the femoral head is seen in both joints, with slightily more intensity in the left side. In Perthes disease and early stage, there is a cold area in the femoral head, which in more advanced course after several months will present with reperfusion and reparative osteoblastic activity.
Meyer dysplasia is a developmental disorder of the hip manifested by delayed, irregular ossification of the femoral epiphysial nucleus. It has a benign clinical course that may resemble severe hip diseases and could be misdiagnosed with osteomyelitis or Perthes disease. Patients may present with limping in one side. The disease evolves between 2 year and 6 year of age and resolves spontaneously.
References:
Harel L, Kornreich L, Ashkenazi S, Rachmel A, Karmazyn B, Amir J. Meyer dysplasia in the differential diagnosis of hip disease in young children. Arch Pediatr Adolesc Med. 1999 Sep;153(9):942-5.