| خلاصه مقاله | Normal skeletal development in the pediatric
ankle is dynamic and often produces variable
imaging appearances that are subject to
misinterpretation. This is especially true as the
use of MRI in the evaluation of musculoskeletal
trauma and growing popularity of and level of
competition in organized sports, among the
pediatric population increases the demand
for clinical assessment of acute and overusetype
athletic injuries. Pre ossification and
secondary ossification centers in the ankle
may be inconsistent in morphology, MRI signal
intensity, and number and imaging pitfalls of
normal physeal development such as Kump
bump, a normal physeal undulation, or focal
periphyseal edema (FOPE) can be misinterpreted
as physeal injury or bar formation. Because of
the high fluid like T2-weighted signal intensity
of pre-ossification centers, their enhancement,
and rounded morphology, they can be
misinterpreted as cysts, abscesses, or neoplasms
and distinguishing features include absence of
associated soft-tissue, cartilaginous, or bone
marrow edema about the pre-ossificationcenters and Their characteristic location, within
the cartilage precursor, without extension
into bone or the physis. Follow-up imaging,
which is rarely necessary, shows the eventual
disappearance of the pre-ossification centers as
they become replaced by secondary ossification
centers. Primary Ossification Centers refer to
the ossification masses of the tibial and fibular
diaphysis and of the hind foot tarsal bones
(referred to the talus and calcaneus bones). This
ossification centers are partially ossified in the
prenatal period and Therefore, these centers are
visualized radiographically from birth. |