Ophthalmology Corporation, USA
Title: Mirror-Image identical twins presenting in mirror-image hip cysts: A case report and review of the literature
Dr. Julia Song is an ophthalmologist in Pasadena, California and is affiliated with multiple hospitals in the area, including Duke University Hospital and Garden Grove Hospital and Medical Center. She received her medical degree from Northwestern University Feinberg School of Medicine and has been in practice for 17 years. Dr. Song accepts several types of health insurance, listed below. She is one of 146 doctors at Duke University Hospital and one of 10 at Garden Grove Hospital and Medical Center who specialize in Ophthalmology. She also speaks multiple languages, including Spanish.
Introduction: One-third of twins are monozygotic. Of monozygotic twins, 25% of them are mirror images. Mirror-imaging occurs when pathologic conditions are present on opposites sides of the body . There are several reports to date of mirror-image heterotaxy, dentition, branchial arch syndrome, strabismus, and cleft lip/palate. This is the first case report of mirror-image identical twins with opposite hip pain who were found to have small cysts of the femoral head on opposite hips.
Methods: Case presentation and review of literature.
Results: 38 year-old mirror-image Asian female identical twins presented with hip pain on opposite sides. MRI demonstrated a 4 mm. cyst of the anterior aspect of the left hip, the femoral head and neck junction, with a herniation pit on opposite sides. The right-handed twin had the cyst on the right hip, and the left-handed twin had the cyst on the left hip.
Conclusions: Mirror-image pathology in mirror-image monozygotic twins suggests possible cytogenetic factors involved in the etiology of various medical problems. If an identical twin presents with a medical problem, it may be recommended to perform a medical diagnostic work-up on the other twin.