Related Experiment Video
Updated: Jun 18, 2025
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Imaging of the Pediatric Knee
Carlos Yaya-Quezada1, Lewis Fanney1,2, Vandan Patel1,3,4
1Section of Musculoskeletal Imaging, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Insights
Normal knee development can present imaging findings that mimic pathology. This review details developmental variants in immature knee joints, distinguishing normal findings from injury-prone conditions.
Area of Science:
- Pediatric Radiology
- Orthopedic Imaging
- Skeletal Development
Background:
- Immature knee imaging findings can mimic pathology or indicate areas of weakness.
- Understanding normal developmental variants is crucial for accurate diagnosis in pediatric patients.
- Age and skeletal maturation significantly influence knee joint imaging appearance.
Purpose of the Study:
- To review the developmental anatomy of the immature knee joint.
- To outline age- and maturation-dependent imaging considerations.
- To describe various developmental variants and their differentiation from pathology.
Main Methods:
- Review of developmental anatomy and imaging characteristics of the immature knee.
- Categorization of variants by anatomical compartment: tibiofemoral, patellofemoral, soft tissues, and osseous components.
- Discussion of differential diagnoses for common imaging mimics.
Main Results:
- Detailed description of tibiofemoral variants (e.g., FOPE, ossification variants, metaphyseal irregularities).
- Explanation of patellofemoral variants (e.g., partite patella, dorsolateral defect, overuse syndromes, avulsion fractures).
- Review of soft tissue (e.g., discoid meniscus, ACL variants) and osseous variants (e.g., fabella, meniscal ossicle).
Conclusions:
- Recognizing normal developmental variants in the immature knee is essential to avoid misdiagnosis.
- Distinguishing developmental variants from true pathology ensures appropriate patient management.
- This review provides a framework for interpreting complex pediatric knee imaging findings.
Abstract:
During normal development, imaging findings in the immature knee joint may mimic pathology or indicate transient sites of weakness, prone to injury. This article reviews the development of the knee joint, age- and maturation-dependent imaging considerations, and various developmental variants that can be encountered, subdivided into those that involve the tibiofemoral and patellofemoral compartments, soft tissues, and osseous components. The tibiofemoral compartment section reviews the focal periphyseal edema zone (FOPE), ossification variants of the femoral condyles, distal femoral metaphyseal cortical irregularity from periosteal traction, and the metaphyseal subperiosteal stripe, which should be distinguished from pathologic mimickers such as endochondral ossification dysfunction, osteochondritis dissecans (OCD), fibroosseous lesion, periosteal and subcortical pathologies. The patellofemoral compartment section includes a review of partite patella, dorsolateral defect, variant trochlear morphology, and maturation-dependent sites of transient weakness that are prone to injury from repetitive overuse (Sinding-Larsen-Johansson syndrome and Osgood-Schlatter disease) and avulsion fractures (patellar sleeve and tibial tubercle avulsions). Finally, soft tissue (discoid lateral meniscus, meniscal flounce, anterior cruciate ligament variants) and osseous components (meniscal ossicle, fabella, and cyamella) are reviewed.
Related Concept Videos
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called...
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:24X-ray Imaging