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December 1954

METAPHYSEAL DYSPLASIA, EPIPHYSEAL DYSPLASIA, DIAPHYSEAL DYSPLASIA, AND RELATED CONDITIONS: II. Multiple Epiphyseal Dysplasia; Its Relation to Other Disorders of Epiphyseal Development

Author Affiliations


From the Department of Medicine of the Harvard Medical School and the Medical Service and the Department of Radiology of the Massachusetts General Hospital.

AMA Arch Intern Med. 1954;94(6):886-901. doi:10.1001/archinte.1954.00250060020002

MULTIPLE epiphyseal dysplasia, described by Barrington-Ward in 1912,1 has 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 Jansen 9 and 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 dysplasia 3 does 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