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Serial kasus: Pengukuran serial dalam penyakit blount dan korelasinya dengan prognosis terapi

Abstract

A child development always plays a major role to their quality of life, particularly about musculoskeletal development. Blount disease is a local growth disturbance which characterized by disorganized enchondral ossification (osteochondrosis) of the medial portion of the epiphyseal and metaphyseal area of the proximal tibia. A 3 years old and a 5 years old male, came with major complaint of bowing legs. Radiograph was performed and showed tibia vara deformity, confirmed with abnormal tibia-femoral angle and meta-diaphyseal (Drennan) angle and medial tibial beaking which are confirmed as Blount disease. Monthly radiographic examination follow-up was performed after surgery and showed improvement of tibia-femoral angle and Drennan angle. Normal value was achieved at 3 months follow up for both patient. In this case series, both Blount disease were diagnosed solely using conventional radiograph using tibia-femoral angle and Drennan angle, as addition of medial tibial beaking patognomonic finding. Blount disease, can be easily diagnosed through measurements and its patognomonic finding seen in conventional radiograph. Corrective surgery should be done before 4 years of age for better outcome. Conventional radiograph is essential not only for confirming diagnosis but also to evaluate treatment outcome.

 

Tumbuh kembang pada masa kanak-kanak selalu memegang peranan penting dalam menentukan kualitas hidup, khususnya perkembangan muskuloskeletal. Penyakit Blount adalah gangguan pertumbuhan lokal yang ditandai ossifikasi enkondral (osteokondrosis) pada medial epifisis dan metafisis tibia proksimal. Perubahan hasil pengukuran sudut pada foto konvensional kaki adalah cara yang mudah dilakukan tapi cukup spesifik untuk membantu menegakkan diagnosis dan koreksi dini dapat membuat perbaikan yang signifikan. Anak lelaki berusia 3 tahun dan 5 tahun datang dengan keluhan bengkok pada kaki. Pemeriksaan radiologi konvensional dilakukan dan menunjukkan adanya deformitas varus tibia, dikonfirmasi dengan hasil pengukuran sudut tibio-femoral dan sudut meta-diafisis (Drennan) yang abnormal, disertai penonjolan (beaking) medial tibia, yang menegaskan penyakit Blount. Pada kedua kasus ini, penyakit Blount didiagnosis hanya dengan menggunakan pemeriksaan radiologi konvensional, yaitu pengukuran sudut tibio- femoral dan sudut Drennan, sebagai tambahan dari penemuan khas penonjolan (beaking) medial tibia. Operasi koreksi harus dilakukan sebelum pasien berusia 4 tahun untuk mendapatkan hasil yang lebih baik. Pemeriksaan radiologis konvensional penting tidak hanya untuk menegakkan diagnosis tetapi juga untuk mengevaluasi hasil terapi.

References

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How to Cite

Maria, D., Martadiani, E. D., & Anandasari, P. P. Y. (2020). Serial kasus: Pengukuran serial dalam penyakit blount dan korelasinya dengan prognosis terapi. Medicina, 51(2). https://doi.org/10.15562/medicina.v51i2.861

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Dessy Maria
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Medicina Journal


Elysanti Dwi Martadiani
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Pande Putu Yuli Anandasari
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