The participation of children and adolescents in sports competitions has recently increased.
Young athletes train more and more professionally,
and as a result,
sports injuries in the pediatric population have been continuously growing.
The presence of cartilaginous physis and apophyses required for skeletal growth,
generate an imbalance in the strength of bones,
tendons,
and ligaments,
which conditions that bones are more prone to acute and chronic injuries than in adults.
Radiologists must know the radiological anatomy and particularities of the musculoskeletal system according to age,
to accurately differentiate a normal variant of the development of a true pathological condition.
Bone Growth
The cartilage of the epiphyseal plate and the epiphysis continues to growth by mitosis,
the chondrocytes of the proximal region to the diaphysis degenerate and die.
The osteoblasts move to the center and ossify the matrix to form bone,
this process persists during childhood and adolescence until the growth stops and the epiphyseal plate becomes completely ossified,
leaving a thin line so that the bones can no longer grow.
Fig.
1
The transverse growth in the diaphysis is produced by intramembranous bone formation in the periosteum,
which consists of an external fibrous layer and an inner layer composed of osteoprogenitor cells.
The musculoskeletal system in childhood
It is in childhood when the long bones have more significant growth in length and thickness,
secondary centers of ossification develop at the ends.
The growth depends on the primary physis,
the secondary physis surrounding the epiphysis,
providing a spherical configuration.
The pediatric skeleton is continuously changing and is susceptible to injuries due to the fragility of the growth cartilage.
The ligaments,
muscles,
and tendons also grow,
which generates an imbalance in strength and flexibility that predisposes even more to children who participate in athletic activities to injure themselves.
The injuries associated with sports can be divided into acute and chronic.
Acute injuries are caused by an excessive force of tension,
load or torsion,
the symptoms appear after the trauma,
may correspond to avulsions,
osteochondral fractures,
bone bruises,
fractures of the growth plate and dislocation of joints.
Chronic injuries correspond to excessive use that generates repetitive microtrauma.
The symptoms have an insidious onset,
and the severity is variable,
depending on the intensity and duration of the physical activity.
Young athletes are at risk of acute and chronic injuries.