Premature epiphyseal closure in an adolescent treated by retinoids for acne: An unusual cause of anterior knee pain

Details

Serval ID
serval:BIB_AFE381CD978D
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Premature epiphyseal closure in an adolescent treated by retinoids for acne: An unusual cause of anterior knee pain
Title of the conference
SOFMER 2011, 26e Congrès de la Société Française de Médecine Physique et de Réadaptation
Author(s)
Eggel Y., Luthi F., Theumann N.
Address
Nantes, France, 13-15 octobre 2011
ISBN
1877-0657
ISSN-L
1877-0657
Publication state
Published
Issued date
2011
Volume
54
Series
Annals of Physical and Rehabilitation Medicine
Pages
e203
Language
english
Abstract
Introduction.- Retinoids are effective and widely used for the treatment of severe acne. Their use can be, however, associated with numerous side effects. For example, some rare cases of premature epiphyseal closure were reported.Observation.- A sixteen-year-old soccer player consulted for bilateral progressive anterior knee pain, since two months, evoking a femoro-patellar origin. After physiotherapy, the pain decreases on the right but remained on the left. The history taking brought out the use of isotretinoin for more than 6 months (0.5 mg/kg). Magnetic resonance imaging (MRI) findings showed an irregularity of the growth plate and an important metaphyso-epiphyseal oedema, more marked on the left. The diagnosis of retinoid induced premature ephysieal closure was retained. The treatment was stopped, with a resolution of symptoms within two months. The control MRI of the left knee present persisting small sequelar thumbprint-like growth plate lesion. Eighteen months later, neither limb-length discrepancy nor static disorder was noticed.Discussion.- Premature epiphyseal closure is a rare complication of retinoid treatment of acne. Retinoids induce an invasion of the growth plate by osteoclasts and a decrease in proteoglycans synthesis. The knee seems the most involved joint. The clinical presentation is aspecific, sometimes lightly symptomatic. A careful pharmacological history and an appropriate imaging are necessary. MRI is now the gold standard. It shows an irregularity of the growth plate with an oedema on both sides. In chronic phase, a thumbprint-like image may persist. The symptoms resolution arises in few weeks after the treatment interruption. A single case of static disorder was reported until now. The small size of the growth plate interruptions, insufficient to lead to a growth disorder if the medicament is stopped early enough, explains probably it. This complication being rare, a radiological follow-up of the young patients treated by retinoids is not proposed.
Create date
15/02/2012 17:00
Last modification date
20/08/2019 16:19
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