Abstract
Objective
To explore how the size of the growth plate changes with age using three-dimensional (3D) models of the distal femoral and proximal tibial growth plates in pediatric patients.
Design and patients
We retrospectively created 3D models of the normal unaffected distal femoral (n=20) and proximal tibial (n=10) growth plates in 14 patients (9 males, 5 females) age range 3.8–15.6 years who were referred for evaluation of premature partial closure of the growth plate or hyaline cartilage abnormality. All patients had one or more 3D fat-suppressed spoiled GRASS sequence from which models were made of normal growth plates. Total projected area was estimated from standardized maximum intensity projection (MIP) views, and volume was computed from the entire model. We also included the total projected area of the distal femur (n=7) or proximal tibia (n=8) in 11 patients (8 males, 3 females, 5–13 years) who had previously been evaluated for bone bridging.
Results
The 3D femoral and tibial growth plate anatomy was displayed. Femoral growth plate area varied from 804 mm2 to 3,463 mm2. Femoral physeal cartilage volume varied from 2.1 cm3 to 12.6 cm3. Tibial growth plate area varied from 736 mm2 to 3,026 mm2. Tibial physeal cartilage volume varied from 1.9 cm3 to 13.2 cm3. The growth plate area values appear to increase linearly with increasing age.
Conclusions
The distal femoral and proximal tibial physeal plates have complex anatomy. Both area and volume of the growth plates appeared to follow a linear increase with age and reached a plateau in adolescence, although there was some scatter. Area appears to have less measurement variability than volume, and may be a more reliable predictor of growth plate tissue quantity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Harcke HT, Snyder M, Caro PA, Bowen JR. Growth plate of the normal knee: evaluation with MR imaging. Radiology 1992; 183:119–123.
Chung T, Jaramillo D. Normal maturing distal tibia and fibula: changes with age at MR imaging. Radiology 1995; 194:227–232.
Jaramillo D, Hoffer FA. Cartilaginous epiphysis and growth plate: normal and abnormal MR imaging findings. AJR Am J Roentgenol 1992; 158:1105–1110.
Sasaki T, Ishibashi Y, Okamura Y, Toh S. MRI evaluation of growth plate closure rate and pattern in the normal knee joint. J Knee Surg 2002; 15:72–76.
Barnewolt CE, Shapiro F, Jaramillo D. Normal gadolinium-enhanced MR images of the developing appendicular skeleton. I. Cartilaginous epiphysis and physis. AJR Am J Roentgenol 1997; 169:183–189.
Craig JG, Cramer KE, Cody D, et al. Premature partial closure and other deformities of the growth plate: MR imaging and three dimensional modeling. Radiology 1999; 210:835–843.
Johnstone EW, Foster BK. The biologic aspects of children’s fractures. In: Beatty JH, Kasser JR, eds. Rockwood and Wilkins’ fractures in children, 5th edn. Philadelphia: Lippincott, Williams and Wilkins, 2001:21–47.
Acknowledgements
The authors thank Ronald Baker for his help in creating the 3D models.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Craig, J.G., Cody, D.D. & van Holsbeeck, M. The distal femoral and proximal tibial growth plates: MR imaging, three-dimensional modeling and estimation of area and volume. Skeletal Radiol 33, 337–344 (2004). https://doi.org/10.1007/s00256-003-0734-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-003-0734-x