J Korean Soc Radiol.  2013 Aug;69(2):153-156. 10.3348/jksr.2013.69.2.153.

Magnetic Resonance Imaging Findings of Periosteal Interposition in a Distal Tibial Salter-Harris Type I Fracture with Surgical Correlation: A Case Report

• Kim N
• Jung JY
• Kang KS

• KMID: 2208820
• DOI: http://doi.org/10.3348/jksr.2013.69.2.153

Abstract

The complication of growth disturbance after physeal fracture of the distal tibia has been well recognized. Although irreducible fractures of the physis due to trapped soft tissue, including periosteum, are not common, it could still cause growth disturbances. Therefore, the detection of periosteal interposition with physeal injury on imaging study is important. We present a case of a 10-year-old girl with surgically confirmed periosteal interposition in the distal tibial Salter-Harris type I fracture, through magnetic resonance imaging findings.

MeSH Terms

Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Periosteum
Tibia

Figure

• 

  Fig. 1 Periosteal interposition in a distal tibial Salter-Harris type I fracture in 10-year-old girl. A. Coronal reformatted image of left ankle CT scan shows a widening of the medial aspect of distal tibial physis (arrowheads), suggesting Salter-Harris type I fracture. Fracture of distal fibular shaft is also noted (arrow). B. Follow-up radiograph (one month after trauma) shows physeal widening (4 mm width) of medial portion of the distal tibia (arrowheads) and fracture of distal fibular shaft (arrow). C-F. Sagittal (C, D) and coronal (E) T2-weighted images show linear low signal structure (arrowhead) in the anteromedial physis of the distal tibia representing entrapped periosteum and surrounding thick intermediate to low signal lesion (arrow) which is suspected as granulation tissue. Axial T2-weighted image (F) obtained at level of physis shows low signal periosteum (arrowhead) and broad intermediate to low signal lesion (arrow) trapped in anteromedial growth plate of distal tibia. G. Intraoperative photograph of distal tibia shows a widening of physis (arrowheads), up to 4-mm width. The entrapped periosteum is clearly removed.

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