Sir,
In a previous article in this journal we referred to the now well-known Bowdler spur manifestation of hypophosphatasia [1]. These transverse smoothly marginated spurs of bone near the convex side of the midshaft of bent long bones are associated with a deep skin dimple visible on radiographs. The Bowdler spurs have been repeatedly seen in hypophosphatasia since first reported by Denby Bowdler at the 1970 meeting of the Gesellschaft für Pädiatrische Radiologie in Zürich (as quoted in [2]).
We have now encountered similar Bowdler spurs in a 20-year-old woman with camptomelic dysplasia, associated with the bowed bones, which are a defining feature of this dysplasia (Fig. 1). The broad protrusion of the tibia seen on radiographs of the same patient on the second day of life, opposite the cutaneous dimple (Fig. 1), was not initially perceived as the Bowdler spur that was evident later in life.
Because the reason for Bowdler spurs in hypophosphatasia is not known, the finding of a similar manifestation in camptomelic dysplasia implies that some unidentified disturbance of cartilage growth associated with certain bowed bones may be responsible.
References
Oestreich AE, Bofinger MK (1989) Prominent transverse (Bowdler) bone spurs as a diagnostic clue in a case of neonatal hypophosphatasia without metaphyseal irregularity. Pediatr Radiol 19:341–342
Kozlowski K, Sutcliffe J, Barylak A et al (1976) Hypophosphatasia. Review of 24 cases. Pediatr Radiol 5:103–117
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None
Rights and permissions
About this article
Cite this article
Oestreich, A.E. Bowdler spur also found in camptomelic dysplasia. Pediatr Radiol 46, 300 (2016). https://doi.org/10.1007/s00247-015-3471-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-015-3471-0