Injuries to the muscle-tendon-bone complex may be acute or chronic. The effect of acuteintrinsic, forced muscle contraction on the muscle-tendon-bone complex changes with increasing skeletal maturity, whilst extrinsic blunt trauma will produce similar appearances across all age groups. The appearance of chronic overuse injuries will also vary depending on whether the apophysis has fused. During the course of this presentation we will explore the imagingfeatures of injury to the muscle-tendon bone complex in the paediatric population.

York Hospital catchment population is around 350 000 with 56 000 <16 years. Musculoskeletal injuries are a common reason for imaging in all age groups but the pattern of injury and imaging approach will vary with patient age and skeletal maturity. Plain films are often the initial imaging modality employed.In young children, ultrasound is often used before MRI as the procedure is well tolerated, quick and does not require sedation or GA which may be necessary to prevent movement artefact in MRI evaluation. In adults...

In general skeletal muscle attaches to bone via a muscle tendon bone complex (figure 1), the type of injury varies with age, muscle and skeletal maturity, type of sporting activity and mechanism of injury. Intrinsic or Distraction Injuries: Intrinsic or distraction injuries occur with forced muscle contraction and are common in running sports requiring sudden acceleration, weightlifters and gymnasts (ref). Injury occurs from sudden eccentric contraction while the muscle is being lengthened during activity. Predisposing factors which increase risk of this type of injury include:...

The pattern of injuryto the muscle-tendon-bone complex and the imaging algorithmwill change with increasing skeletal maturity. It is important that radiologists are aware of these changes and the common imaging findings so that the best method of imaging can be employed.

1. Peetrons P. Ultrasound of muscles. Eur Radiol 2002;12:35-43 2. Valle M, Martinoli C, Miguel-Perez M, Tendon injuries in Children and adolescents, MUSoc 2012 3. Pisacano RM, Miller TT, (2003) Comparing sonography with MR imaging of apophyseal injuries of the pelvis in 4 boys, AJR AmJ Roentgenol 181:223-230 4. Paterson A. Soccer injuries in children. Pediatr Radiol 2009;39:1286-1298 5. Perry D, Bruce C. Evaluating the child who presents with an acute limp BMJ 2010;341:c4250 6. Jain N, et al. Radiological approach to a child with...

Dr Howarth is a final year resident on the Leeds Bradford Training scheme, UK, the work was carried out whilst at York Hospital. Dr Kingston is a Consultant Radiologist at York Hospital, Wigginton Road, York, YO31 8HE, UK.