Presentation
Elite junior AFL footballer with low grade knee ache. No acute injury, normal physical examination.
Patient Data
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 edema signal radiating outward from this bony bar into the metaphysis and epiphysis, i.e., "periphyseal edema".
Minimal joint effusion.
No other abnormal findings.
Case Discussion
Classic appearance of a focal periphyseal edema zone (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 edema 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.