MRI of pediatric growth plate injury: correlation with plain film radiographs and clinical outcome.
OBJECTIVE
To evaluate pediatric growth plate injuries with conventional radiographs and magnetic resonance imaging (MRI). To review potential clinical impact of MRI on subsequent patient management and outcome.


METHODS
Fourteen patients with known or suspected growth plate injury were studied. Each patient underwent imaging by conventional radiography and MRI within 2 weeks of injury. Findings on conventional radiographs and on MR images were compared and then correlated with subsequent management and outcome at a mean of 12 months.


RESULTS
Direct visualization of cartilage afforded by MRI improved evaluation of growth plate injury in each case. MRI changed Salter Harris classification or staging in 2 of 9 patients with fractures visualized on conventional radiographs, allowed the detection of radiographically occult fractures in 5 of 14 cases, and resulted in a physical change in management in 5 of the 14 patients studied.


CONCLUSIONS
MRI has an important role in the evaluation of acute pediatric growth plate injury, particularly when diagnostic uncertainty persists following the evaluation of conventional radiographs. MRI allows detection of occult fractures, may alter Salter Harris staging, and in the reported study it frequently resulted in a change in patient management.
Carey
J
J
Department of Radiology, Boston Medical Center, MA 02118, USA.
Spence
L
L
Blickman
H
H
Eustace
S
S
D000293:Adolescent; D016512:Ankle Injuries / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D050723:Fractures, Bone / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005596:Fractures, Closed / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D006132:Growth Plate / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D006810:Humeral Fractures / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D010347:Patient Care Planning; D011859:Radiography; D011885:Radius Fractures / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D000072042:Salter-Harris Fractures; D013978:Tibial Fractures / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome