The prevalence of pseudoepiphyses in the metacarpals of the growing hand

Normally the metacarpals have an epiphysis at one end--distally for the second to fifth and proximally for the first. Pseudoepiphyses are notches or clefts that occur at the non-epiphyseal ends of bones where an epiphyseal plate would be expected and are common incidental findings in the metacarpals of the growing hand. We aimed to identify the prevalence of pseudoepiphyses on serial radiographs of 610 healthy asymptomatic children. Pseudoepiphyses in the form of notches or clefts were common, identified most often in the second metacarpal (15.25%), fifth metacarpal (7.21%), and third metacarpal (0.49%). Complete pseudoepiphyses, in which the cleft extended across the full width of the metacarpal, were seen in the first metacarpal (1.97%) and the second metacarpal (1.31%). Pseudoepiphyses are a normal variant of metacarpal ossification and should not be confused with fractures in skeletally immature patients.