Focal periphyseal oedema zone

Case contributed by Dr Yuan Ling

Presentation

Elite junior AFL footballer with low grade knee ache. No acute injury, normal physical examination.

Patient Data

Age: 14 years
Gender: Male
Modality: MRI

The growth plates have begun to close. PD sequence shows a focus of sclerosis along the medial aspect of the distal femoral growth plate, representing a bony bar across the physis.

PD FS sequence shows marrow oedema signal radiating outward from this bony bar into the metaphysis and epiphysis, i.e., "periphyseal oedema".

Minimal joint effusion. 

No other abnormal findings.

Case Discussion

Classic appearance of a FOPE lesion in the appropriate demographic.

As the skeleton begins to mature, a bony bar may form across the growth plate as it closes. This focal bridge is thought to serve as an anchor around which abnormal biomechanical stress can concentrate, manifested as radiating marrow oedema signal.

This is considered a normal physiologic process that can result in pain. The diagnosis is considered especially when there are no other abnormal findings.

This condition requires no further investigation, treatment or follow-up.

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Case Information

rID: 38731
Case created: 31st Jul 2015
Last edited: 17th Sep 2015
Inclusion in quiz mode: Included

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