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Related Experiment Videos

Normal maturing distal tibia and fibula: changes with age at MR imaging

T Chung1, D Jaramillo

  • 1Department of Radiology, Children's Hospital, Harvard Medical School, Boston, MA 02115.

Radiology
|January 1, 1995
PubMed
Summary

Magnetic resonance (MR) imaging reveals a predictable pattern of bone development in the maturing distal tibia and fibula. Understanding these normal MR imaging findings is crucial for accurate diagnosis in pediatric patients.

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Area of Science:

  • Pediatric Radiology
  • Musculoskeletal Imaging
  • Anatomy

Background:

  • The distal tibia and fibula undergo significant developmental changes during childhood and adolescence.
  • Accurate interpretation of magnetic resonance (MR) imaging in pediatric patients requires knowledge of normal evolving anatomy.

Purpose of the Study:

  • To characterize the typical appearance of the developing distal tibia and fibula on MR imaging.
  • To establish a reference for normal maturation patterns in pediatric lower extremities.

Main Methods:

  • Retrospective analysis of 50 MR examinations in patients aged 2 months to 21 years.
  • Patients were categorized into six developmental groups based on distal tibia and fibula morphology.
  • Evaluation of epiphyseal ossification, physeal closure, and physeal cartilage signal characteristics.

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Main Results:

  • Distal tibial epiphyseal ossification and physeal closure initiate anteromedially, preceding the fibula.
  • An anteromedial undulation (Kump hump) in the tibial physis can mimic premature closure due to volume averaging.
  • The cartilaginous epiphysis exhibits lower signal intensity than the physis on T2-weighted images.
  • Optimal visualization of the physis is achieved with gradient-recalled-echo and fat-suppressed spin-echo proton-density-weighted sequences.

Conclusions:

  • Maturation of the distal tibia and fibula follows a consistent pattern of cartilaginous and bone development.
  • MR imaging effectively demonstrates these normal developmental changes, aiding in the differentiation from pathology.