Magnetic resonance assessment of inversion ankle injuries in children

A cohort of ten children with X-ray negative inversion ankle injuries were studied using Magnetic Resonance Imaging. The images obtained were scored on six pathological criteria. Despite all ten having normal plain radiographs, 50 per cent were found to have direct evidence of growth plate injury. Seventy per cent of the cohort had periosteal elevation including all those with evidence of growth plate injury. This study supports previous work which suggested that children with 'X-ray' negative acute inversion ankle injuries who exhibited the clinical signs of injury to their lower fibular growth plate most probably have an undisplaced Salter-Harris Type 1 fracture of this structure, despite normal radiographs.