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The periphysis and its effect on the metaphysis: I. Definition and normal radiographic pattern
1Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-2899.
Insights
The periphysis, including the zone of Ranvier and ring of LaCroix, forms a normal metaphyseal collar in children. This structure, particularly the periphyseal bone bark, should not be misdiagnosed as fractures or rickets.
Area of Science:
- Pediatric Radiology
- Skeletal Development
- Histology
Background:
- The periphysis, comprising the zone of Ranvier and ring of LaCroix, contributes to the metaphyseal collar in young children.
- Understanding the normal appearance of the periphyseal bone bark is crucial for accurate radiological interpretation.
Purpose of the Study:
- To define the periphysis and its radiological appearance in infants and young children.
- To differentiate normal periphyseal structures from pathological findings like fractures or rickets.
Main Methods:
- Descriptive analysis of periphyseal structures and their radiological manifestations.
- Radiological assessment of the metaphyseal collar and periphyseal bone bark in pediatric populations.
Main Results:
- The normal metaphyseal collar at the wrist measures 1-3 mm in width during the first 7 years of life.
- The periphyseal bone bark is visible in 9% of infants at the distal ulna and can be mistaken for fracture or rickets.
- The step-off at the periphyseal margin should not be confused with abuse fractures.
Conclusions:
- The periphysis and its associated bone bark are normal anatomical structures in pediatric skeletal development.
- Radiologists must be aware of these normal findings to avoid misdiagnosis of fractures, rickets, or abuse in children.
Abstract:
The zone of Ranvier and the ring of LaCroix, together with the membranous bone bark they produce, are termed the periphysis in order to emphasize their normal effect (the metaphyseal collar) on the metaphysis of the infant and young child. In the first 7 years of life, the normal collar at the wrist is 1-3 mm wide. The step-off between the metaphyseal collar and the curvilinear metaphysis, at the margin of the periphysis, should not be mistaken for abuse fracture. The periphyseal bone bark may be radiologically visible at the edge of the physis at the distal ulna in 9% of infants and should not be mistaken for fracture or rickets.