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Deformidade postero-medial congénita da tíbia: a propósito de 2 casos clínicos
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Advisor(s)
Abstract(s)
RESUMO
Objetivo: Apresentar o caso de duas crianças com encurvamento
dos membros inferiores condicionado por deformidades
angulares da tíbia e discutir os seus diagnósticos diferenciais.
Descrição do caso: Apresenta-se o caso de duas crianças
referenciadas a uma consulta de Ortopedia Pediátrica por
encurvamento dos membros inferiores. Não apresentavam manchas
cutâneas ou outras particularidades ao exame objetivo. O
exame clínico e imagiológico foi compatível com deformidade
póstero-medial congénita da tíbia. A evolução clínica foi favorável,
com resolução espontânea da deformidade e sem dismetria
dos membros.
Discussão: A deformidade póstero-medial congénita da tíbia
é uma entidade rara, havendo escassos casos relatados. A sua
incidência real permanece desconhecida. Implica o diagnóstico
diferencial com pseudartrose congénita da tíbia, quase sempre
relacionada com a neurofibromatose. A maioria das vezes o tratamento
é conservador, atendendo a que tende a resolver espontaneamente
(a maioria até aos 8 anos), sem qualquer repercussão
clínica. Pretende-se alertar os Pediatras, para que estabeleçam
a possibilidade desta entidade clínica perante um encurvamento
dos membros inferiores, minimizando a ansiedade parental que
dela resulte, ressalvando-se no entanto a importância de que sejam
observados por ortopedistas atendendo a que há situações
clínicas em que o diagnóstico pode não ser tão evidente.
ABSTRACT Objective: To describe the case of two children with leg bowing conditioned by tibial angular deformities and to discuss differential diagnosis. Case report: We report the case of two patients referred to a Pediatric Orthopedics Consultation due to leg bowing. No skin patches or other alterations were found on physical examination. Clinical and imaging findings were consistent with congenital posteromedial bowing of the tibia. Favorable outcome was verified, with spontaneous resolution of deformity. Comments: Posteromedial bowing of the tibia is a rare entity, with few cases reported in literature. Its true incidence remains unknown. It implies differential diagnosis with the tibial congenital pseudarthrosis, usually related to neurofi bromatosis. Most often its treatment is conservative, because it tends to resolve spontaneously (mostly under 8 years) without any clinical consequences. Our aim is to alert pediatricians to establish the possibility of this clinical entity when dealing with tibial bowing, minimizing parental anxiety resulting from it. Nevertheless we emphasize the importance of evaluation by an orthopedist as there are clinical situations in which diagnosis may not be as evident.
ABSTRACT Objective: To describe the case of two children with leg bowing conditioned by tibial angular deformities and to discuss differential diagnosis. Case report: We report the case of two patients referred to a Pediatric Orthopedics Consultation due to leg bowing. No skin patches or other alterations were found on physical examination. Clinical and imaging findings were consistent with congenital posteromedial bowing of the tibia. Favorable outcome was verified, with spontaneous resolution of deformity. Comments: Posteromedial bowing of the tibia is a rare entity, with few cases reported in literature. Its true incidence remains unknown. It implies differential diagnosis with the tibial congenital pseudarthrosis, usually related to neurofi bromatosis. Most often its treatment is conservative, because it tends to resolve spontaneously (mostly under 8 years) without any clinical consequences. Our aim is to alert pediatricians to establish the possibility of this clinical entity when dealing with tibial bowing, minimizing parental anxiety resulting from it. Nevertheless we emphasize the importance of evaluation by an orthopedist as there are clinical situations in which diagnosis may not be as evident.
Description
Keywords
Deformidades congénitas das extremidades inferiores tíbia criança Congenital lower extremity deformities tibia child
Citation
Nascer e Crescer 2013; 22(3): 171-173