• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
bone and spine logo

Bone and Spine

Your Trusted Resource for Orthopedic Health Information

  • Home
  • About
  • Contact Us
  • Policies
  • Show Search
Hide Search
You are here: Home / Pediatric ortho / Dysplasia Epiphysealis Hemimelica or Trevor Disease

Dysplasia Epiphysealis Hemimelica or Trevor Disease

Dr Arun Pal Singh ·

Last Updated on October 29, 2023

Dysplasia epiphysealis hemimelica or Trevor disease rare, a non-hereditary disease characterized by osteochondromas arising from the epiphyses.

The incidence is about 1 in 1 million. Males are three times more commonly affected than females.

The condition was first described in 1926 by Mouchet and Belot and then by Trevor in 1950. The term dysplasia epiphysealis hemimelica was coined by Fairbank in 1956.

It is thought to be a variant of osteochondroma arising from an epiphysis.

Though it is a benign disorder, in its natural history, the lesion continuously increases in size until skeletal maturity [Just like osteochondroma] leading to pain and arthrosis.

Typically, only one half of the epiphysis is involved bur involvement of the entire epiphysis is known. The medial side of the epiphysis is most commonly affected

It usually presents in young children. The lower extremity is more common than upper extremity and distal ends are more affected especially on the medial side. The distal femur and talus, navicular and first cuneiform joint are most commonly affected.

Reconstructed CT image of tibial lesion of dysplasia epiphysealis hemimelica, Image courtsey From the case Dr Preetam Gongidi/Radiopaedia
Reconstructed CT image of tibial lesion of dysplasia epiphysealis hemimelica, Image courtesy From the case Dr Preetam Gongidi/Radiopaedia [Image cropped for better appearance]
Contents hide
1 Classification
1.1 Classic Form
1.2 Localized Form
1.3 Generalized form
2 Causes of Dysplasia Epiphysealis Hemimelica
3 Presentation of Dysplasia Epiphysealis Hemimelica
4 Differential Diagnoses
5 Imaging
5.1 Xrays
5.2 CT
5.3 MRI
6 Treatment of Dysplasia Epiphysealis Hemimelica
7 Complications
8 Outcome and Prognosis

Classification

By Azouz et al

Classic Form

The distribution involves more than one bone or epiphysis within a single lower limb

Localized Form

Single bone is affected either on one side or both sides.

Generalized form

This type involves the whole of the limb from pelvis to foot

Causes of Dysplasia Epiphysealis Hemimelica

The cause is uncertain but is thought to be congenital but is not genetically transmitted.

Presentation of Dysplasia Epiphysealis Hemimelica

Hard painless swelling or a mass on one side of a joint and stiffness are common complaints.

There would be deformity and muscle wasting in the area. Limb length discrepancy could be present. Sometimes, the problem of joint locking can also be complained.

Differential Diagnoses

  • Chondroblastoma
  • Osteochondroma
  • Enchondroma

Imaging

Xrays

Radiographs show an irregular mass with focal ossification arising from one side of the affected epiphysis. Widening of the joint may be noted.

CT

CT is able to define a relation between the mass and its parent bone. It also is useful for evaluation of the articular cartilage and soft tissue.

MRI

MRI depicts the unossified cartilaginous mass and status of the articular cartilage in detail. It is able to differentiate abnormal epiphyseal growth from the main epiphysis.

Treatment of Dysplasia Epiphysealis Hemimelica

The treatment should be carried out if there is a deformity, pain, or interference with function. Excision of the mass and corrective osteotomy with preservation of joint is the usual treatment

No treatment is indicated if there is no symptom or mechanical block ..

In cases where surgery is not required ie. mild symptoms, supportive joint care, joint splintage and other measures to control symptom are taken.

Complications

Recurrence, degenerative osteoarthritis, fixed deformity, leg-length discrepancy, and loose bodies following fragmentation.

Outcome and Prognosis

Untreated dysplasia epiphysealis hemimelica involves joint and can cause considerable disability if not treated.

Recurrence is known.

Pediatric ortho This article has been medically reviewed by Dr. Arun Pal Singh, MBBS, MS (Orthopedics)

About Dr Arun Pal Singh

Dr. Arun Pal Singh is a practicing orthopedic surgeon with over 20 years of clinical experience in orthopedic surgery, specializing in trauma care, fracture management, and spine disorders.

BoneAndSpine.com is dedicated to providing structured, detailed, and clinically grounded orthopedic knowledge for medical students, healthcare professionals, patients and serious learners.
All the content is well researched, written by medical expert and regularly updated.

Read more....

Primary Sidebar

Know Your Author

Dr. Arun Pal Singh is an orthopedic surgeon with over 20 years of experience in trauma and spine care. He founded Bone & Spine to simplify medical knowledge for patients and professionals alike. Read More…

Explore Articles

Anatomy Anatomy Fractures Fractures Diseases Diseases Spine Disorders Spine Disorders Patient Guides Patient Guides Procedures Procedures
featured image for orthopedics traction

Orthopedic Traction – Principles, Types, and Uses

Traction is a fundamental concept in orthopedics for managing …

featured image of gower sign for segmenatal instability of lumbar spine

Clinical Tests for Lumbar Segmental Instability

Lumbar segmental instability may not always be visible on standard …

mesurement of scoliosis for braces

Braces for Scoliosis- Types, Uses and Results

Braces for scoliosis are recommended to prevent the scoliotic curve …

discogenic back pain

Discogenic Back Pain Causes, Diagnosis and Treatment

Discogenic back pain is a common cause of axial low back pain [the …

Elbow arthrodesis using internal fixation

Elbow Arthrodesis- Indications, Methods and Complications

Elbow arthrodesis refers to the surgical fusion of the elbow joint. It …

Popular articles

skeletal traction in upper tibial pin

Skeletal Traction – Indication, Uses and Complications

Skeletal traction is a type of traction …

King classification of scoliosis curves

Classification of Scoliosis Curves

Scoiliotic curves can be classified by …

Philips Head Screw

Bone Screws Used in Orthopedics

Bone screws have been used to fix the …

Reconstructed CT image of tibial lesion of dysplasia epiphysealis hemimelica

Dysplasia Epiphysealis Hemimelica or Trevor Disease

Dysplasia epiphysealis hemimelica or …

Bone and Spine

© 2025 BoneAndSpine.com · All Rights Reserved
The content provided on BoneAndSpine.com is intended for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Read Disclaimer in detail.