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Measuring 3D In-vivo Shoulder Kinematics using Biplanar Videoradiography

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Physes around the shoulder girdle: normal development and injury patterns.

I Anwar¹, D Amiras¹, M Khanna¹

¹Radiology Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK.

Clinical Radiology

|April 27, 2016

Summary

Pediatric scapula and clavicle injuries differ from adult fractures due to developing bones. Advanced imaging like MRI aids in distinguishing dislocations from epiphyseal injuries for better patient management.

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Area of Science:

Orthopedic Surgery
Pediatric Radiology
Skeletal Development

Background:

Traumatic injuries to the scapula and clavicle in pediatric patients present unique challenges compared to adults.
Unossified cartilage and unfused epiphyses in immature skeletons complicate diagnosis on conventional imaging.
Understanding developmental anatomy is crucial for accurate interpretation of pediatric shoulder girdle injuries.

Purpose of the Study:

To highlight the distinct characteristics of scapula and clavicle injuries in skeletally immature patients.
To emphasize the diagnostic difficulties posed by cartilaginous and epiphyseal components on plain radiographs and CT.
To underscore the importance of recognizing developmental anatomy for accurate radiological interpretation.

Main Methods:

Review of imaging characteristics of pediatric scapula and clavicle injuries.
Comparison of diagnostic capabilities of plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI).
Emphasis on the role of knowledge of developmental anatomy in interpreting these injuries.

Main Results:

Fractures involving unossified cartilage and unfused epiphyses are challenging to detect with standard radiography and CT.
Magnetic resonance imaging (MRI) offers improved resolution for differentiating true joint dislocations from epiphyseal injuries.
Accurate distinction between dislocations and epiphyseal injuries impacts patient management and prognosis.

Conclusions:

Radiologists must possess thorough knowledge of pediatric skeletal development to accurately diagnose scapula and clavicle injuries.
Advanced imaging techniques, particularly MRI, are vital for precise diagnosis in skeletally immature patients.
Correctly identifying the nature of the injury (dislocation vs. epiphyseal injury) is critical for optimal patient outcomes.