An epiphyseal cortical irregularity is an anatomical variant featuring a fragmented appearance of the distal femoral epiphysis in children.
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Epidemiology
Epiphyseal cortical irregularity is a rare finding, accounting for 6.7% of all incidental findings on a knee radiograph series 1.
It has a higher prevalence in young children of less than 5 years and it has not been described in children aged 10 years and above 1.
Pathology
Delayed ossification is attributed as a possible cause for this condition 1.
Clinical presentation
This is an asymptomatic anatomical variant.
Radiographic features
Plain radiograph
Plain radiographs are the modality of choice to confirm this diagnosis and may show:
irregular margins with a fragmented appearance of the distal femoral epiphysis, more commonly involving the medial side
minimal beaking or fragmentation at the edge of the metaphyses 2
Ultrasound
It may show hyperechoic lines and spurs inside the epiphyseal cartilage, arising from the ossfied center.
Treatment and prognosis
Epiphyseal cortical irregularity tend to disappear on imaging follow-up. Therefore, it does not require further evaluation nor treatment 1.
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