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Journal: World Journal of

Nuclear Medicine.

Article title: Van Neck–Odelberg

disease: A rare cause of pain in
pediatric pelvis.

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AQ5: Van Neck-Odelberg
1 Left 10
disease or ischiopubic
osteochondritis, is a rare
cause of pain in the
pediatric pelvis due to late
closure in
synchondrosis ischiopubic,
whose main symptom is
an asymmetric pain that
can cause a limitation in
movement or limp. The
different characteristics
by images from simple
radiography, computed
tomography, MRI and
bone scintigraphy scan will
increase certainty
 diagnosis and will allow
the correct differential
diagnosis with fractures,
posttraumatic osteolysis,
infections or tumors, that
leads to unnecessary
invasive procedures, being
this a benign disease with
an evolution and
improvement that occurs
in weeks or months with a
conservative treatment.
A 15-year-old boy case is
presented, he consulted
our hospital with an extra-
institutional diagnosis of
right ischiopubic branch
fracture. After being
evaluated by different
imaging methods,
diagnosis of Van Neck-
Odelberg or ischiopubic
osteochondritis is made.
AQ6:I agree.
1 Left 23

1 Left 40
AQ7: we obtained the

patient's consent.
How to cite this article: AQ15: DANIEL
1 Right 37
Herrera D, Bernal P, HERRERA,
Cifuentes L, Ucros G, PATRICIA BERNAL
Gómez R, Rivero O. Van LUISA CIFUENTES
Neck–Odelberg disease: GONZALO UCROS
A rare cause of pain in RAFAEL GÓMEZ.
pediatric OSCAR RIVERO.
pelvis. World J Nucl Med
 2019;XX:XX-XX.

1 Right 40 AQ2: Luisa Cifuentes.

1 Right 41 AQ3-4: Department of

Radiology, Fundación
Santa Fe de Bogotá.

1 Right 43 AQ4: Fundación Santa Fe

de Bogotá, Bogotá,
Colombia.

2 Left - AQ1: Van Neck–Odelberg

disease: A rare cause of
pain in pediatric pelvis.

2 Left 16
AQ12-13-14:

CONFIRMED.
In radiographies (Figure
1) and CT of the hip, a
hyperostosis of
fusiform morphology will
be observed, due to
hypodense
area inside and bone
callus formation secondary
to increase
in tension that will enlarge
the joint, which creates the
appearance of a
pseudotumor due to its
morphology; cystic
areas of absorption and an
increase in density can
also be

seen later.[5]
 AQ14: MRI (Figure 2) can
2 Left 31
identify more sensitive and
early findings, such as an
increase in signal intensity
in sequences with T2
information
with fatty saturation or
short-tau inversion
recovery,
secondary to bone edema
at the site of
synchondrosis, with
evidence of bone bridges
and cartilage inside of it.
Findings
not only help to rule out a
neoplasm, such as
Ewing’s sarcoma,
increasing diagnostic
certainty,[6] but also might
create
confusion for the final
diagnosis, if there is no
adequate
observer experience.
AQ14: Then, bone
2 Left 51
scintigraphy allows the
detection of an increase
in focal radiotracer uptake
secondary to an abnormal
early osteogenic activity,
and fusion with
tomographic
images (SPECT/CT)
(Figure3) allows a better
anatomical correlation
 which increases its
sensitivity in the diagnosis
of stress at
the level of ischiopubic
synchondrosis.[7,8]
Knowledge of
this pathology is essential
to avoid being confused
with
fracture, posttraumatic
osteolysis, infection, or
tumor in
symptomatic children that
lead to unnecessary
invasive
procedures.
AQ8:
2 Right 28
In this disease, the main
symptom is pain, which
can cause a limitation in
movement or limp, as a
result of mechanical stress
due to excessive traction
of the ischiotibial muscles
at ischiatic tuberosity[3],
which will produce a
delayed closure of this
synchondrosis, and as a
consequence, an
inflammatory reaction and
a delay in the cartilage
junction and the
ossification centers [4].

AQ1: Van Neck–Odelberg

3 Left -
disease: A rare cause of
pain in pediatric pelvis.
 3 Left 19
AQ9: I agree.

AQ10: Osteochondritis of
3 Right 24
pubis.
AQ11: Saha S, Burke C,
3 Right 38
Desai A, Vijayanathan S,
Gnanasegaran G.
SPECT-CT: Applications in
musculoskeletal radiology.
Br J Radiol
2013;86:20120519. P 1-
16.
AQ10: Holsti LR.
3 Right 39
ischiopubic ostechondritis.
Acta Radiol 1956;45:178-
84.

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Journal Title: World Journal of Nuclear Medicine.

Manuscript Title: Van Neck–Odelberg disease: A rare cause of pain in pediatric pelvis.
Manuscript Number: WJNM_67_19.

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Name Signature Date signed

1 Daniel Herrera. 15/11/2019.

2 Patricia Bernal. 15/11/2019.

3 Luisa Cifuentes . 15/11/2019.

4 Gonzalo Ucros. 15/11/2019.

5 Rafael Gómez. 15/11/2019.

6. Oscar Rivero. 15/11/2019.

IMAGES

Figure 1.

Figure 2.
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