Skip to main content
Log in

Femoral morphology and epiphyseal growth plate changes of the hip during maturation: MR assessments in a 1-year follow-up on a cross-sectional asymptomatic cohort in the age range of 9–17 years

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objectives

The goal of this prospective study was to characterize the morphology and physeal changes of the femoral head during maturation using MRI in a population-based group of asymptomatic volunteers.

Materials and methods

Sixty-four pupils (127 hips) of 331 pupils from a primary and high school were asked to take part in this study and were willing to participate. 3T MRI of the hip was obtained at baseline and 1-year follow-up. With these images, we analyzed the femoral morphology and epiphyseal changes related to age, status of the physis, and location on the femur.

Results

The radius of the femoral head and neck increased with age, as expected, (p < 0.001). The epiphyseal extension increased significantly with age (p < 0.05), but epiphyseal tilt and alpha angle showed no differences (p > 0.05). Building groups by using the epiphyseal status, we found that the epiphyseal extension had the highest changes in the "open" group and almost stopped in the "closed" group. The tilt angle did not change significantly (p > 0.05). Significant smaller alpha-angles were found in the "closed" group, however, these were in a normal range in all of them. Correlated to the position, the highest alpha-angle values were located in anterior-superior and superior-anterior position.

Conclusions

Our data can be used as normative values, which can be compared to patients or cohorts with certain risk factors (e.g., professional athletes), this will offer the chance to detect and understand pathological changes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Murphy SB, Ganz R, Müller ME. The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77(7):985–9.

    PubMed  CAS  Google Scholar 

  2. Goodman DA, Feighan JE, Smith AD, Latimer B, Buly RL, Cooperman DR. Subclinical slipped capital femoral epiphysis. Relationship to osteoarthrosis of the hip. J Bone Joint Surg Am. 1997;79(10):1489–97. Erratum in: J Bone Joint Surg Am 1999 Apr;81(4):592. PubMed PMID: 9378734.

    PubMed  CAS  Google Scholar 

  3. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012–8. PubMed PMID: 15972923.

    Article  PubMed  CAS  Google Scholar 

  4. Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466(2):264–72. Epub 2008 Jan 10. Review. PubMed PMID: 18196405; PubMed Central PMCID: PMC2505145.

    Article  PubMed  Google Scholar 

  5. Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 1986;(213):20–33. PubMed PMID: 3780093.

  6. Murray RO. The aetiology of primary osteoarthritis of the hip. Br J Radiol. 1965;38(455):810–24. PubMed PMID: 5842578.

    Article  PubMed  CAS  Google Scholar 

  7. Stulberg SD, Cordell LD, Harris WH. Unrecognized childhood hip disease: a major cause of idiopathic osteoarthrosis of the hip. The Hip Proceedings of the Third Meeting of The Hip Society. (Ed Amstutz HC). C.V. Mosby Company, Saint Louis 1975;212–28.

  8. Eijer H, Myers SR, Ganz R. Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma. 2001;15(7):475–81. PubMed PMID: 11602829.

    Article  PubMed  CAS  Google Scholar 

  9. Ito K, Minka 2nd MA, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoralhead-neck offset. J Bone Joint Surg Br. 2001;83(2):171–6. PubMed PMID: 11284559.

    Article  PubMed  CAS  Google Scholar 

  10. Siebenrock KA, Wahab KH, Werlen S, Kalhor M, Leunig M, Ganz R. Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Relat Res. 2004;418:54–60. PubMed PMID: 15043093.

    Article  PubMed  Google Scholar 

  11. Mamisch TC, Kim YJ, Richolt JA, Millis MB, Kordelle J. Femoral morphology due to impingement influences the range of motion in slipped capital femoral epiphysis. Clin Orthop Relat Res. 2009;467(3):692–8. Epub 2008 Oct 22. PubMed PMID: 18941860; PubMed Central PMCID: PMC2635459.

    Article  PubMed  Google Scholar 

  12. Miese FR, Zilkens C, Holstein A, et al. MRI morphometry, cartilage damage and impaired function in the follow-up after slipped capital femoral epiphysis. Skeletal Radiol. 2010;39(6):533–41. Epub 2010 Feb 24. PubMed PMID: 20177672.

    Article  PubMed  Google Scholar 

  13. Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am. 2003;85-A(2):278–86. PubMed PMID: 12571306.

    PubMed  CAS  Google Scholar 

  14. Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res. 1999;363:93–9. PubMed PMID: 10379309.

    Article  PubMed  Google Scholar 

  15. Eijer H, Berg RP, Haverkamp D, Pécasse GA. Hip deformity in symptomatic adult Perthes' disease. Acta Orthop Belg. 2006;72(6):683–92. PubMed PMID: 17260605.

    PubMed  Google Scholar 

  16. Kassarjian A, Brisson M, Palmer WE. Femoroacetabular impingement. Eur J Radiol. 2007;63(1):29–35. Epub 2007 May 7. Review. PubMed PMID: 17485190.

    Article  PubMed  Google Scholar 

  17. Pfirrmann CW, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J. Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology. 2006;240(3):778–85. Epub 2006 Jul 20. Erratum in: Radiology. 2007 Aug;244(2):626. PubMed PMID: 16857978.

    Article  PubMed  Google Scholar 

  18. Kassarjian A, Belzile E. Femoroacetabular impingement: presentation, diagnosis, and management. Semin Musculoskelet Radiol. 2008;12(2):136–45. Review. PubMed PMID: 18509793.

    Article  PubMed  Google Scholar 

  19. Jaberi FM, Parvizi J. Hip pain in young adults: femoroacetabular impingement. J Arthroplasty. 2007;22(7 Suppl 3):37–42. Review. PubMed PMID: 17919591.

    Article  PubMed  Google Scholar 

  20. Nötzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84(4):556–60. PubMed PMID: 12043778.

    Article  PubMed  Google Scholar 

  21. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;(417):112–20. Review. PubMed PMID: 14646708.

  22. Locher S, Werlen S, Leunig M, Ganz R. [MR-Arthrography with radial sequences for visualization of early hip pathology not visible on plain radiographs]. Z Orthop Ihre Grenzgeb. 2002;140(1):52–7. German. PubMed PMID: 11898065.

    Article  PubMed  CAS  Google Scholar 

  23. Werlen S, Leunig M, Ganz R. Magnetic resonance arthrography of the hip in femoroacetabular impingement: technique and findings operative techniques in orthopaedics. 2005;15(3):191–203.

  24. Eijer H, Leunig M, Mahomed MN, Ganz R. Cross-table lateral radiograph for screening of anterior femoral head-neck offset in patients with femoro-acetabular impingement. Hip Int. 2001;11:37–41.

    Google Scholar 

  25. Wiberg G. Studies on dysplastic acetabulum and congenital subluxation of the hip joint with special reference to the complication of osteoarthritis. JAMA. 1940;115(1):81. doi:10.1001/jama.1940.02810270083038.

  26. Herndon CH, Heyman CH. Legg-Perthes disease; a method for the measurement of the roentgenographic result. J Bone Joint Surg Am. 1950;32(A:4):767–78. PubMed PMID: 14784485.

    PubMed  Google Scholar 

  27. Steppacher SD, Tannast M, Werlen S, Siebenrock KA. Femoral morphology differs between deficient and excessive acetabular coverage. Clin Orthop Relat Res. 2008;466(4):782–90. Epub 2008 Feb 21. PubMed PMID: 18288550; PubMed Central PMCID: PMC2504673.

    Article  PubMed  CAS  Google Scholar 

  28. Sasaki T, Ishibashi Y, Okamura Y, Toh S, Sasaki T. MRI evaluation of growth plate closure rate and pattern in the normal knee joint. J Knee Surg. 2002;15(2):72–6. PubMed PMID: 12013076.

    PubMed  Google Scholar 

  29. Ecklund K, Jaramillo D. Patterns of premature physeal arrest: MR imaging of 111 children. AJR Am J Roentgenol. 2002;178(4):967–72. PubMed PMID: 11906884.

    PubMed  Google Scholar 

  30. Craig JG, Cody DD, Van Holsbeeck M. The distal femoral and proximal tibial growth plates: MR imaging, three-dimensional modeling and estimation of area and volume. Skeletal Radiol. 2004;33(6):337–44. Epub 2004 Apr 3. PubMed PMID: 15064874.

    Article  PubMed  Google Scholar 

  31. Dvorak J, George J, Junge A, Hodler J. Age determination by magnetic resonance imaging of the wrist in adolescent male football players. Br J Sports Med. 2007;41(1):45–52. Epub 2006 Oct 4. PubMed PMID: 17021001; PubMed Central PMCID: PMC2465138.

    Google Scholar 

  32. Ulrich Welsch, Sobotta Lehrbuch Histologie: Zytologie, Histologie, Mikroskopische Anatomie.Seite 142–146 Verlag: Urban & Fischer Verlag; Auflage: 2., völlig überarb. A. (21. August 2006) Sprache: Deutsch ISBN-10: 3437444301.

  33. Tanzer M, Noiseux N. Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthop Relat Res. 2004;(429):170–7. Review. PubMed PMID: 15577483.

  34. Southwick WO. Osteotomy through the lesser trochanter for slipped capital femoral epiphysis. J Bone Joint Surg Am. 1967;49(5):807–35. PubMed PMID: 6029256.

    PubMed  CAS  Google Scholar 

  35. Strout PE, Fleiss JL. Intraclass Correlations: Uses in Assessing Rater Reliability. Psychology Bulletin. 1979;86:420–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karl-Philipp Kienle.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kienle, KP., Keck, J., Werlen, S. et al. Femoral morphology and epiphyseal growth plate changes of the hip during maturation: MR assessments in a 1-year follow-up on a cross-sectional asymptomatic cohort in the age range of 9–17 years. Skeletal Radiol 41, 1381–1390 (2012). https://doi.org/10.1007/s00256-012-1358-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-012-1358-9

Keywords

Navigation