MRI evaluation of the development of intercondylar notch width in children
Marcin E Domzalski1, Marc S Keller, Piotr Grzelak
1Departments of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland, marcin.domzalski@umed.lodz.pl.
Insights
The intercondylar notch width index (NWI) in children decreases with age, while the ratios of the anterior and posterior cruciate ligaments (ACL/PCL) to the notch increase. Age is a key factor in analyzing pediatric knee development.
Area of Science:
- Pediatric imaging
- Orthopedic research
- Biomechanical analysis
Background:
- The intercondylar notch houses crucial knee ligaments.
- Understanding pediatric knee growth is vital for injury prevention and treatment.
- Intercondylar notch dimensions may influence anterior cruciate ligament (ACL) injury risk.
Purpose of the Study:
- To assess the developmental changes in intercondylar notch width in children using MRI.
- To investigate the relationship between cruciate ligaments (ACL and PCL) and intercondylar notch width during growth.
Main Methods:
- MRI and medical records of 76 children (3.8-16.9 years) without knee derangements were reviewed.
- Measurements of intercondylar notch, knee, ACL, and PCL width were taken from standardized coronal MRI views.
- Calculated metrics included notch width index (NWI) and various ligament-to-notch/knee width ratios.
Main Results:
- NWI demonstrated a statistically significant correlation with age, decreasing from younger to older children.
- While ACL/knee width and PCL/knee width ratios remained proportional with age, ACL/notch and PCL/notch ratios increased.
- These findings suggest a relative narrowing of the intercondylar notch compared to ligament size during growth.
Conclusions:
- Intercondylar notch width index (NWI) decreases with age in children, transitioning from childhood to adolescence.
- The relative increase in ACL/notch and PCL/notch ratios is associated with the decrease in NWI.
- Age should be considered a critical cofactor in studies analyzing NWI in pediatric populations.
Purpose:
The purpose of this study was to evaluate the development of intercondylar notch width in children using MRI and assesse the relationship between the cruciate ligaments and the width of the intercondylar notch during growth.
Methods:
We reviewed MRIs and medical records of 76 children (age range 3.8-16.9) without derangements of the knee. Cases with knee joint instability and/or major trauma were excluded. On a standardized coronal image, measurements of the width of the intercondylar notch, knee, ACL and PCL were performed using image analysis software. The notch width index (NWI), ACL/notch, ACL/knee width, PCL/notch, and PCL/knee width were calculated.
Results:
NWI showed statistical correlation with age. The highest values were found in the youngest children, and the lowest in the oldest group. While ACL/knee width, and PCL/knee width ratios remained proportional over time, the ACL/notch, and PCL/notch ratios increased with the age of the patient.
Conclusion:
NWI changes with age and decreases from childhood to adolescence. A relative decrease in NWI accounts for an increase in the ACL/notch and PCL/notch ratios with age. Studies about NWI in children should consider age as a cofactor for analysis.
