Paediatric Knee Radiographs: Normal Appearances of the Knee Joint in the Growing Patient

Congress:

ESSR 2015

Poster Number:

P-0124

Type:

Educational Poster

Keywords:

Education and training, Education, Plain radiographic studies, Paediatric, Musculoskeletal joint

Authors:

C. Chisholm, D. Mak, M. Thyagarajan; Birmingham/UK

DOI:

10.1594/essr2015/P-0124

DOI-Link:

https://dx.doi.org/10.1594/essr2015/P-0124

Learning objectives

Knowledge of the plain radiograph appearances of the paediatric knee joint at different stages of development.

Background

Ossification in the knee joint in particular the patella in children can lead to confusing appearacnes on plain radiograph. This poster will outline the normal ossification pattern in the knee joint through childhood and adolescence and highlight any normal variants that can mimic pathology.

Imaging findings OR Procedure Details

Ossification of the femur, tibia, fibula and patella is a process that starts in utero and continues through to the age of 18. The femoral shaft begins ossification at 8 weeks in utero. The distal femur then begins to ossify at 3-6 months (Fig. 1). At birth the distal femoral epiphysis is in a transverse plane and as children start to walk it is exposed to shearing forces which cause the physis to develop an undulating appearance. The femur continues to grow until the distal...

Conclusion

Knowledge of the order and ages of ossification is important in accurate interpretation of the paediatric knee radiograph to prevent misdiagnosis and inappropriate intervention.

References

Ryan S, McNicholas M, Eustace S. Anatomy for Diagnostic Imaging. Saunders Ltd. 3rd Edition. 2010 Ogden JA. Radiology of postnatal skeletal development. X. Patella and tibial tuberosity. Skeletal Radiol. 1984;11(4):246-57.

Personal Information

Dr Cass Chisholm, Radiology ST3, West Midlands Deanery. Dr Davina Mak, Radiology ST3 West Midlands Deanery. Dr Manigandan Thyagarajan,Radiology Consultant, Birmingham Childrens Hospital.