EURORAD ESR

Case 14569

Trapped periosteum managed conservatively

Author(s)
Daniel R. Poulsen, Jason S. Chu, Arthur Yegorov

SUNY Upstate Medical University,
Syracuse, New York;
Email:poulsend@upstate.edu
 
Patient
female, 6 year(s)
 
 
  • Figure 1
    Anterior posterior radiograph

    Widened lateral physis of right femur.

     
    Area of Interest: Bones; Imaging Technique: Digital radiography; Procedure: History; Special Focus: Pathology;
     
     
  • Figure 2
    MRI sagittal fluid-sensitive sequence

    Increased signal along physis of distal femur with surrounding oedema in metaphysis and adjacent epiphysis (lower left arrow). Fluid collection at posterior adjacent soft tissue represents periosteal and capsular...

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Pathology;
     
     
  • Figure 3
    Coronal T1-weighted MR

    Prominent low signal region at physis (arrow) indicates trapped periosteum.

     
    Area of Interest: Extremities; Imaging Technique: MR; Procedure: History; Special Focus: Pathology;
     
     
  • Figure 4
    Coronal proton density fat-suppressed MR

    Proton density imaging highlights adjacent bone marrow oedema. Low prominent signal is again appreciated indicating trapped periosteum (arrow).

     
    Area of Interest: Bones; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Athletic injuries;
     
     
  • Figure 5
    Axial MR demonstrating periosteal injury

    A segment of missing periosteum is seen at the posterior lateral aspect of the distal femur near the metaphysis.

     
    Area of Interest: Bones; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Pathology;
     
     
  • Figure 6
    Axial MR images demonstrating trapped periosteum

    A few slices more inferiorly a well trapped periosteum is seen.

     
    Area of Interest: Bones; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Pathology;
     
     
Widened lateral physis of right femur.
 
Increased signal along physis of distal femur with surrounding oedema in metaphysis and adjacent epiphysis (lower left arrow). Fluid collection at posterior adjacent soft tissue represents periosteal and capsular injury (upper right arrow).
 
Prominent low signal region at physis (arrow) indicates trapped periosteum.
 
Proton density imaging highlights adjacent bone marrow oedema. Low prominent signal is again appreciated indicating trapped periosteum (arrow).
 
A segment of missing periosteum is seen at the posterior lateral aspect of the distal femur near the metaphysis.
 
A few slices more inferiorly a well trapped periosteum is seen.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version