Epiphyseal and physeal injury: comparison of conventional radiography and magnetic resonance imaging.

PURPOSE: To compare conventional radiography and magnetic resonance imaging (MRI) in the assessment of epiphyseal and physeal injury.

MATERIALS AND METHODS: Seventeen cases with epiphyseal and physeal injury were examined with conventional radiography and MRI. Two blinded experienced radiologists separately evaluated the results retrospectively.

RESULTS: Two Salter-Harris II fractures showed displacement of epiphysis and metaphyseal fragment, as well as T1 hypointensity and T2 hyperintensity in the physis on MRI. Three Salter-Harris IV fractures showed a fracture line in the epiphysis and metaphysis on two modalities, as well as linear T2 hyperintensity in the physis. All five slipped epiphysis showed signal intensity abnormality in the physis on MRI aside from the physeal widening and epiphyseal displacement seen on radiographs. Seven patients with bony bridge formation showed premature closure of the physis, shortening, and remodeling of the end of bones involved.

CONCLUSIONS: Conventional radiography and MRI are both useful in the diagnosis of epiphyseal and physeal injury. MRI can provide more detailed information, which could direct treatment planning and prognosis predicting.