PMC7364762_01
Plain radiograph of a skeletal lesion in the lumbar spine L1 of a 3-year-old boy managed conservatively. (A) Marked flattening of L1, vertebra plana. (B) Gradual remodeling and restoration of the height after 1-year follow-up. (C) Remodeling after 2 years. (D) Complete restoration of height after 5-year follow-up, child age 8 years.
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F1
Figure 1 shows spontaneous complete restoration of vertebral height and complete remodeling in first lumbar vertebra in a 3-year-old girl.
Plain radiograph of cervical spine of a 12-year-old boy diagnosed with LCH showing destruction and atlanto-axial instability, surgery was mandated to avoid neurological affection. (A) Preoperative plain radiograph showing C1-C2 instability. (B) CT scan showing the instability and lateral tilt of C1 over C2. (C) Postoperative radiograph showing C1-C2 fixation. (D) Follow-up radiograph after 1 year. (E) Follow-up CT scan after 5 years showing complete fusion of C1-C2.
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F2
Two patients were surgically treated by anterior and posterior fixation at the level C1-C2 and C7-T1 (Figure 2).
PMC7364762_02
Plain radiograph of the left hip of a 5-year-old boy diagnosed with LCH in the femoral neck managed conservatively. (A) Pathologic fracture of the left femoral neck on top of lytic lesion. (B) Healing of the fracture after 3 months. (C) Remodeling of the femoral neck at 1 year of follow-up. (D) Complete remodeling after 7-year follow-up.
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F3
Plain radiographic evidence of complete remodeling of the femoral neck and correction of the varus deformity was observed one year following presentation, in a 4-year-old child who presented with fracture and coxa vara angulation of the femoral neck (Figure 3).
Plain radiograph of forearm of a 5-year-old girl diagnosed with LCH showing large osteolytic lesion of the ulna managed conservatively. (A and B) Anteroposterior and lateral views showing the large sized osteolytic lesion of the ulna. (C) Follow-up after two years showing partial remodeling. (D) Follow-up radiograph showing complete remodeling.
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F4
Three lesions resulted in marked expansion of the proximal part of involved radius and ulna reaching the articular surface; however, all were treated conservatively with complete healing and full range of motion of the elbow joint (Figure 4).