Focal periphyseal edema (FOPE zone) - hip

Case contributed by Dalia Ibrahim

Presentation

Left hip pain.

Patient Data

Age: 15 years
Gender: Male

Left femoral focal periphyseal edema signal.

Case Discussion

On clinical follow-up 1 month later, the patient reported resolution of the hip pain.

Focal periphyseal edema (FOPE zone) on MRI of the adolescents is a potentially painful manifestation of the physiologic physeal fusion in the immature skeleton of the adolescents provoked by the stress of physeal closure as they approach fusion.

MR features include focal discontinuity of the growth plate representing the first location of bone fusion of the metaphysis and epiphysis. The transphyseal bone trabecular around these focal areas has reduced pliability and reacts to physiological stress in adolescents by provoking periphyseal edema signal. Usually, there's resolution of the patient's pain and MRI periphyseal edema on follow-up studies.

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