Bone bruising of the distal forearm and wrist in children.
Bone bruising represents a new category of bone injury that can only be demonstrated by magnetic resonance imaging (MRI) with fat suppression. This study proposed the nature of non-radiographically evident injuries of the distal radius and wrist in children whose symptoms did not resolve after 5 weeks. We aimed to describe and classify the lesions and delineate the importance and potential complications of the injuries. Bone bruising was diagnosed in 20 patients (mean age: 11.6 years; range: 9-13 years). Bone bruises were classified according to anatomical location and whether they were solitary lesions or were combined with other injuries. Injuries of the distal radius were classified according to location: type 1 was localised to the metaphysis, close to the physeal plate; type 2 involved both the metaphysis and diaphysis; and type 3 extended on both sides of the distal radial growth plate. The type 1 injuries were consistent with complete, un-displaced Salter-Harris type I fractures, whilst type 3 lesions were potentially Salter-Harris type V injuries. Our data indicate that an MRI should be considered for a child with an injury to the distal radius or wrist whose symptoms do not resolve after 5 weeks of immobilisation.
Sferopoulos
Nikolaos K
NK
Department of Paediatric Orthopaedics, Aristotle University of Thessaloniki, P. Papageorgiou 3, 54635 Thessaloniki, Greece. sferopoulos@in.gr
D000293:Adolescent; D002348:Carpal Bones / Q000293:injuries* / Q000473:pathology; D002370:Casts, Surgical; D002648:Child; D003288:Contusions / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005592:Fracture Fixation / Q000379:methods; D005596:Fractures, Closed / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D006132:Growth Plate / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011885:Radius Fractures / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D000072042:Salter-Harris Fractures