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Imaging appearances of musculoskeletal developmental variants in the pediatric population
Netanel S Berko1, Jessica Kurian1, Benjamin H Taragin1
1Department of Radiology, Montefiore Medical Center, Bronx, NY.
Insights
Pediatric musculoskeletal imaging can reveal normal developmental variants that mimic disease. Radiologists can confidently identify these benign conditions by recognizing specific imaging features, avoiding unnecessary interventions.
Area of Science:
- Pediatric Radiology
- Skeletal Development
- Medical Imaging
Background:
- Musculoskeletal developmental variations in children are frequent.
- These variants can present imaging findings that resemble pathological conditions.
- Distinguishing benign variants from true pathologies is crucial for accurate diagnosis.
Purpose of the Study:
- To review common categories of pediatric musculoskeletal developmental variants.
- To highlight characteristic imaging features that differentiate benign variants from pathological lesions.
- To emphasize the importance of recognizing these variants in radiological practice.
Main Methods:
- Review of literature focusing on pediatric musculoskeletal development.
- Analysis of imaging characteristics of common normal variants.
- Discussion of differential diagnostic features between variants and pathologies.
Main Results:
- Four main categories of developmental variants are discussed: ossification variations, tendinous/ligamentous insertions, overlapping lines, and variant bone orientation.
- Characteristic imaging features allow for confident identification of benign variants.
- Clinical correlation may be necessary in some cases, but imaging features often suffice.
Conclusions:
- Radiologists must be aware of common musculoskeletal developmental variants in children.
- Recognizing specific imaging features aids in differentiating benign variants from pathological conditions.
- Accurate identification of variants prevents misdiagnosis and unnecessary patient workup.
Abstract:
Variations in musculoskeletal development in children are commonly encountered. These variants often have a confusing appearance on imaging and may simulate pathologic conditions. However, in many instances, these normal variants have certain features that allow for confident determination of the benign nature of these entities. An awareness of the characteristic imaging features is therefore important for radiologists. In this review, we focus on 4 specific categories of variants in the development: (1) variations in the normal ossification of skeletal structures, (2) the appearance of tendinous and ligamentous insertions in the developing skeleton, (3) overlapping lines that can be confused with fractures or other pathologic conditions, and (4) variant orientation of normal bones. We review the etiology and imaging appearance of these entities and also describe methods of differentiating these benign entities from pathologic lesions. Although in certain cases, correlation with clinical parameters is needed to confidently diagnose the lesion as benign, in many cases, an appreciation of the characteristic imaging features alone would suffice and prevent a potentially costly workup.
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