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MR findings of bowlegs in toddlers
T Iwasawa1, Y Inaba, G Nishimura
1Department of Radiology, Yokohama City University School of Medicine, Yokohama, Japan.
Insights
Magnetic resonance imaging (MRI) can predict the progression of tibial bowing in toddlers. These findings may help identify children at risk for developing Blount
Area of Science:
- Pediatric Orthopedics
- Radiology
- Biomedical Engineering
Background:
- Severe physiologic tibial bowing in toddlers is a potential risk factor for Blount's disease.
- Early identification of at-risk children is crucial for timely intervention.
Purpose of the Study:
- To correlate magnetic resonance (MR) imaging findings with clinical outcomes in toddlers exhibiting severe physiologic tibial bowing.
- To assess the predictive value of MR imaging for the development of Blount's disease.
Main Methods:
- MR imaging was performed on 22 affected legs in 14 children (mean age 1.9 years) with severe tibial bowing.
- MR findings were compared with serial measurements of the tibial metaphyseal-diaphyseal angle (MDA) and tibiofemoral angle (TFA) between 2 and 3 years of age in 18 legs.
Main Results:
- MR findings included posteromedial physeal undulation, medial tibial metaphyseal signal alterations, T2 prolongation in the posteromedial tibial epiphyseal cartilage, and medial meniscal signal changes.
- Differential changes in TFA and MDA were observed based on the presence of epiphyseal cartilage signal alterations and physeal undulation, respectively.
Conclusions:
- MR imaging findings can predict the retarded resolution of tibial bowing.
- These MR imaging findings may serve as indicators for the risk of developing Blount's disease.
Background:
Toddlers with severe physiologic tibial bowing are considered to be at risk for the development of Blount's disease. Objective. To correlate MR findings of the knee with the clinical outcome in toddlers with severe physiological tibial bowing.
Materials And Methods:
MR findings were evaluated in 22 affected legs of 14 children with severe tibial bowing (mean age 1.9 years). In 18 affected legs, MR findings were compared with the transition of the tibial metaphyseal-diaphyseal angle (MDA) and tibiofemoral angle (TFA) measured serially between 2 and 3 years of age.
Results:
MR findings of severe tibial bowing comprised undulation of the posteromedial physis of the tibia (3/22), signal alterations in the medial tibial metaphysis (10/22), T2 prolongation in the posteromedial tibial epiphyseal cartilage (14/22) and signal changes in the medial menisci (18/22). The decrease in the TFA was different in the legs with and without increased signal in the epiphyseal cartilage, and the decrease in the MDA was different in the legs with and without physeal undulation.
Conclusion:
MR imaging findings can predict the retarded resolution of tibial bowing, which may be a risk factor for the development of Blount's disease.