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Yang XR, Wen R, Yang N, Zhang TN. Role of sirtuins in sepsis and sepsis-induced organ dysfunction: A review. Int J Biol Macromol 2024; 278:134853. [PMID: 39163955 DOI: 10.1016/j.ijbiomac.2024.134853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 08/16/2024] [Accepted: 08/16/2024] [Indexed: 08/22/2024]
Abstract
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis causes a high mortality rate and current treatment focuses on supportive therapies but lacks specific therapeutic targets. Notably, sirtuins (SIRTs) shows potential clinical application in the treatment of sepsis. It has been demonstrated that SIRTs, the nicotinamide adenine dinucleotide+(NAD+)-dependent deacetylases that regulate key signaling pathways in eukaryotes and prokaryotes, are involved in a variety of biological processes. To date, seven mammalian yeast Sir2 homologs have been identified. SIRTs can regulate inflammation, oxidative stress, apoptosis, autophagy, and other pathways that play important roles in sepsis-induced organ dysfunction. However, the existing studies on SIRTs in sepsis are too scattered, and there is no relevant literature to integrate them. This review innovatively summarizes the different mechanisms of SIRTs in sepsis organ dysfunction according to the different systems, and focuses on SIRT agonists, inhibitors, and targeted drugs that have been proved to be effective in the treatment of sepsis, so as to integrate the clinical research and basic research closely. We searched PubMed for all literature related to SIRTs and sepsis since its inception using the following medical subject headings: sirtuins, SIRTs, and sepsis. Data on the mechanisms of SIRTs in sepsis-induced organ damage and their potential as targets for disease treatment were extracted.
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Affiliation(s)
- Xin-Ru Yang
- Department of Pediatrics, PICU, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Ri Wen
- Department of Pediatrics, PICU, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Ni Yang
- Department of Pediatrics, PICU, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Tie-Ning Zhang
- Department of Pediatrics, PICU, Shengjing Hospital of China Medical University, Shenyang 110004, China.
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Balloufaud M, Hosni S, Bolivar J, Saguintaah M, Virassamy M, Laffont I, Coulet B, Lambert K, Delpont M. Subscapularis impairment on magnetic resonance imaging is correlated with functional limitations in neonatal brachial plexus palsy. INTERNATIONAL ORTHOPAEDICS 2024; 48:1635-1643. [PMID: 38167960 DOI: 10.1007/s00264-023-06081-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The relationship between functional shoulder deficits in children with neonatal brachial plexus palsy (NBPP) and magnetic resonance imaging (MRI) shoulder abnormalities was evaluated. METHODS Shoulder function was assessed in 16 children (mean age: 5.8 years; range: 3-12 years) with NBPP based on shoulder rotator muscle strength, as measured using an isokinetic dynamometer and the modified Mallet score. The thickness and fatty infiltration of the subscapularis and infraspinatus muscles, and the morphology of the glenoid on MRI, were also determined. RESULTS The highest subscapularis fatty infiltration subgroup of NBPP patients promoted the highest alteration muscle thickness and modified Mallet score. CONCLUSIONS In NBPP children, subscapularis impairments play a major role in the functional limitations. This study of pediatric NBPP patients highlighted the value of adding an examination of the muscles to routine MRI assessment of bone parameters in the shoulders of NBPP children. TRIAL REGISTRATION NCT03440658.
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Affiliation(s)
- Maxime Balloufaud
- PhyMedExp, CNRS UMR 9214, INSERM U1046, University of Montpellier, Montpellier, France
| | - Sarah Hosni
- Orthopedic Pediatric Surgery Department, Lapeyronie Hospital, CHU Montpellier, University of Montpellier, 191 Avenue du Doyen Gaston Giraud, 34295, Montpellier, France
| | - Julie Bolivar
- Pediatric Radiology, Arnaud De Villeneuve Hospital, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Magali Saguintaah
- Pediatric Radiology, Arnaud De Villeneuve Hospital, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Maxime Virassamy
- Orthopedic Pediatric Surgery Department, Lapeyronie Hospital, CHU Montpellier, University of Montpellier, 191 Avenue du Doyen Gaston Giraud, 34295, Montpellier, France
| | - Isabelle Laffont
- Physical Medicine and Rehabilitation Department, CHU Montpellier, University of Montpellier, Montpellier, France
- Euromov, UFR STAPS, University of Montpellier, Montpellier, France
| | - Bertrand Coulet
- Euromov, UFR STAPS, University of Montpellier, Montpellier, France
- Orthopedic Surgery, Upper Extremity, Hand and Peripheral Nerve Surgery Department, Lapeyronie Hospital, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Karen Lambert
- PhyMedExp, CNRS UMR 9214, INSERM U1046, University of Montpellier, Montpellier, France
| | - Marion Delpont
- PhyMedExp, CNRS UMR 9214, INSERM U1046, University of Montpellier, Montpellier, France.
- Orthopedic Pediatric Surgery Department, Lapeyronie Hospital, CHU Montpellier, University of Montpellier, 191 Avenue du Doyen Gaston Giraud, 34295, Montpellier, France.
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Galán-Olleros M, Egea-Gámez RM, Palazón-Quevedo Á, Martínez-Álvarez S, Suárez Traba OM, Pérez ME. Normal ossification of the glenoid mimicking a glenoid fracture in an adolescent patient: a case report. Clin Shoulder Elb 2023; 26:306-311. [PMID: 36330717 PMCID: PMC10497921 DOI: 10.5397/cise.2022.01151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/14/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
A 13-year-old male was diagnosed with a glenoid fracture following direct shoulder trauma, for which surgical treatment was considered. After referral to a center for pediatric orthopedic care, physical examination, contralateral shoulder X-ray, and detailed computed tomography examination ruled out the presence of fracture; these findings were later confirmed by magnetic resonance imaging. Normal ossification patterns in the adolescent shoulder may simulate a fracture in traumatic settings. To accurately diagnose and manage pediatric shoulder pathology, orthopedic surgeons must be aware of the normal anatomy of the growing shoulder, its secondary ossification centers, and growth plates.
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Affiliation(s)
- María Galán-Olleros
- Department of Pediatric Orthopedics and Department of Orthopedic Surgery and Traumatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Rosa M. Egea-Gámez
- Department of Pediatric Orthopedics and Department of Orthopedic Surgery and Traumatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Ángel Palazón-Quevedo
- Department of Pediatric Orthopedics and Department of Orthopedic Surgery and Traumatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Sergio Martínez-Álvarez
- Department of Pediatric Orthopedics and Department of Orthopedic Surgery and Traumatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Olga M. Suárez Traba
- Department of Diagnostic Imaging, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Marta Escribano Pérez
- Department of Diagnostic Imaging, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Knapik DM, Do MT, Fausett CL, Liu RW. An anatomic and 3D study of the development of the proximal humeral physis. Surg Radiol Anat 2022; 44:869-876. [PMID: 35476149 DOI: 10.1007/s00276-022-02946-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE During maturation, the ossification centers of the proximal humerus form a characteristic pattern consisting of a metaphyseal peak and corresponding epiphyseal valley. The surface topographies of the metaphyseal peak and epiphyseal valley are not well described and may have variation with age and structural importance to the pathogenesis of proximal humeral epiphysiolysis. METHODS High-resolution 3-dimensional surface scans of 24 cadaveric proximal humeral epiphyses and metaphyses in specimens aged 3 to 18 years were obtained. Computer modeling software was used to measure the peak height of the metaphysis and maximal depth of the epiphysis relative to a perpendicular line drawn across the proximal humeral physis. RESULTS The metaphyseal peak had a mean height of 12.7 ± 1.6 mm while the epiphyseal valley had a mean depth of 13.1 ± 2.1 mm, both consistently positioned in the posterolateral quadrant. Both the absolute metaphyseal peak height (R2 = 0.536; p < 0.001) and absolute epiphyseal valley depth (R2 = 0.524; p < 0.001) increase with advancing age. Multiple linear regression analysis demonstrated that normalized metaphyseal peak height + sex (adjusted R2 = 0.408; p < 0.002) correlated more with age than normalized epiphyseal valley depth + sex (adjusted R2 = 0.128; p < 0.091). CONCLUSION Prominence of the metaphyseal peak and epiphyseal valley both increase with advancing age, with a lower correlation between normalized sizes with age as compared to the absolute sizes, suggesting that these structures stay relatively proportional with growth.
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Affiliation(s)
- Derrick M Knapik
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, 63110, USA
| | - Michael T Do
- Division of Pediatric Orthopaedic Surgery, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11000 Euclid Avenue, RBC 6081, Cleveland, OH, 44106, USA
| | - Cameron L Fausett
- Department of Orthopaedic Surgery, Stanford Medicine, Redwood City, CA, 94063, USA
| | - Raymond W Liu
- Division of Pediatric Orthopaedic Surgery, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11000 Euclid Avenue, RBC 6081, Cleveland, OH, 44106, USA.
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Naňka O, Bartoníček J, Havránek P. Diagnosis and Treatment of Scapular Fractures in Children and Adolescents: A Critical Analysis Review. JBJS Rev 2022; 10:01874474-202202000-00006. [PMID: 35171874 DOI: 10.2106/jbjs.rvw.21.00132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Fractures of the growing scapula account for about 0.1% of all pediatric fractures, with the majority occurring at an age of ≥10 years. » Radiographic diagnosis requires a detailed knowledge of the ossification sequence of the growing scapula. Computed tomography examination is indicated for displaced fractures of the glenoid fossa, the scapular neck, and complex fractures; magnetic resonance imaging should be performed in cases of suspected injury to the physis and with stress fractures, depending on patient age and the potential need for general anesthesia during the scanning process. » Separation of the base of the coracoid process is often associated with acromioclavicular dislocation. Clavicular fractures rarely occur in combination with injuries to the growing scapula. » The majority of scapular fractures can be treated nonoperatively. Indications for surgery are displaced intra-articular fractures, scapular neck fractures with a displacement of >2 cm, coracoid base separation associated with acromioclavicular dislocation, and scapulothoracic dissociation. » Displaced intra-articular fractures of the glenoid fossa should be followed after healing until skeletal maturity. Complications are rare and occur most frequently with scapulothoracic dissociation.
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Affiliation(s)
- Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Pediatric and Trauma Surgery, 3rd Faculty of Medicine, Charles University, Thomayer Teaching Hospital, Prague, Czech Republic
| | - Jan Bartoníček
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Orthopaedics, First Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic
| | - Petr Havránek
- Department of Pediatric and Trauma Surgery, 3rd Faculty of Medicine, Charles University, Thomayer Teaching Hospital, Prague, Czech Republic
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Sidharthan S, Greditzer HG, Heath MR, Suryavanshi JR, Green DW, Fabricant PD. Normal Glenoid Ossification in Pediatric and Adolescent Shoulders Mimics Bankart Lesions: A Magnetic Resonance Imaging-Based Study. Arthroscopy 2020; 36:336-344. [PMID: 31901390 DOI: 10.1016/j.arthro.2019.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/17/2019] [Accepted: 08/03/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this descriptive study was to define patterns of ossification and fusion of growth centers around the pediatric and adolescent glenoid as a function of age using 3-dimensional, frequency-selective, fat-suppressed spoiled gradient recalled echo magnetic resonance (MR) imaging sequences, with a particular focus on the anterior glenoid rim because of its clinical relevance as a potential confounder of glenohumeral instability. METHODS Picture Archiving and Communication System records at an urban academic tertiary care orthopaedic facility from October 2005 to December 2018 were queried for shoulder MRI in patients aged 9 to 17 years. Patients were excluded if they had any diagnoses that could alter glenoid development. All images were independently evaluated by a musculoskeletal fellowship-trained radiologist. Secondary ossification centers were characterized as cartilage anlage, ossified, or fused at 3 anatomic sites: the anterior glenoid rim, coracoid, and superior glenoid rim. RESULTS A total of 250 MR examinations (143 males, 107 females) were assessed in this study. The glenoid develops in a predictably sequential manner with ossification at the anterior glenoid rim lagging behind the coracoid and superior glenoid rim. The earliest age of anterior glenoid rim ossification was 11 years for both males (range 11-17) and females (range 11-12). Anterior glenoid rim ossification peaked at age 16 among males (34.8%, 8/23) and age 11 among females (27.3%, 3/11). CONCLUSIONS Glenoid ossification and fusion progress in a predictable and chronological manner. This pattern should be used as a guideline when interpreting pediatric shoulder MRI examinations. In particular, an anterior glenoid ossification center should not be confused with an anterior glenoid injury (e.g., Bankart lesion), particularly in males 11 to 17 years old and females 11 to 12 years old. LEVEL OF EVIDENCE IV (case series).
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Affiliation(s)
- Sreetha Sidharthan
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Harry G Greditzer
- Division of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA
| | - Madison R Heath
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Joash R Suryavanshi
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Daniel W Green
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Peter D Fabricant
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
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Normal development imaging pitfalls and injuries in the pediatric shoulder. Pediatr Radiol 2019; 49:1617-1628. [PMID: 31686168 DOI: 10.1007/s00247-019-04512-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/27/2019] [Accepted: 08/12/2019] [Indexed: 10/25/2022]
Abstract
The skeletal maturation of the shoulder has been well documented on radiographic and cadaveric studies. Recent increased use of MRI has provided increased understanding of the soft-tissue and osseous changes that occur during development. Thus recognizing normal maturation, imaging manifestations and pitfalls is crucial when evaluating the pediatric shoulder joint. At birth, the humeral diaphysis, midportion of the clavicle, and the body of the scapula are ossified, while the remainder of the bones of the shoulder are composed of non-ossified cartilaginous precursors. During growth, cartilaginous apophyses and epiphyses of the shoulder develop numerous secondary ossification centers, which fuse with the primary ossification centers to form the complete bony components of the shoulder. Additionally changes in the morphology of the growth plates as well as marrow signal occur in an organized manner. This paper affords the reader with an understanding of the normal development of three major components of skeletal maturation in the shoulder: ossification centers, growth plates and marrow signal. These topics are further subdivided into the glenoid, proximal humerus and acromioclavicular joint. We also provide a focus on distinguishing normal anatomy from imaging pitfalls related to skeletal maturation.
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Akromioklavikulargelenk. Radiologe 2019; 59:257-272. [DOI: 10.1007/s00117-019-0495-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Djebbar S, Rosenberg ZS, Fitzgerald Alaia E, Agten C, Zember J, Rossi I. Imaging features of glenoid bare spot in a pediatric population. Skeletal Radiol 2018; 47:45-50. [PMID: 28823051 DOI: 10.1007/s00256-017-2755-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/14/2017] [Accepted: 08/02/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The bare spot (BaS) is a central, well-circumscribed focal defect in the glenoid articular surface, with reported adult incidence of 1-2%. We aimed to reassess MRI features of BaS in the pediatric population and determine its etiology. MATERIALS AND METHODS A retrospective search of our database from June 2014 to October 2015 was performed for shoulder MRI in patients between 5 and 25 years and then subdivided into four groups: group 1, 5-10 years; group 2, 10-15 years; group 3, 15-18 years; group 4, 20-25 years. BaS was defined as a well-marginated, central defect of increased signal in the articular surface of the glenoid, seen on at least two planes, without evidence of underlying glenoid pathology. Presence, location and size along with clinical indications were documented. RESULTS A final cohort of 253 patients revealed 23 BaS, 3.5% in group 1, 20% in group 2, 5% in group 3 and 4% in group 4. There was a significantly higher incidence in group 2 (p = 0.007) compared to group 3 and p = 0.002 compared to group 4. Location was mainly central. Mean size was significantly bigger in group 2 compared to group 3 and 4. Distribution showed the highest number at 14-15 years of age. Instability was higher in groups 3 and 4. CONCLUSION Incidence of BaS in group 2 was significantly higher than in other age groups and higher than in adults. BaS was also larger compared to other populations. These findings support a developmental theory, explained by the centripetal ossification of the glenoid.
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Affiliation(s)
- Sahlya Djebbar
- Center for Musculoskeletal Care, NYU Langone Medical Center, 333 E 38th St, New York, NY, 10016, USA.
| | - Zehava Sadka Rosenberg
- Center for Musculoskeletal Care, NYU Langone Medical Center, 333 E 38th St, New York, NY, 10016, USA
| | - Erin Fitzgerald Alaia
- Center for Musculoskeletal Care, NYU Langone Medical Center, 333 E 38th St, New York, NY, 10016, USA
| | - Christoph Agten
- Center for Musculoskeletal Care, NYU Langone Medical Center, 333 E 38th St, New York, NY, 10016, USA
| | - Jonathan Zember
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Ignacio Rossi
- Centro Rossi, Arenales 2777, C1425BEE, Buenos Aires, Argentina
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Delgado J, Jaramillo D, Chauvin NA. Imaging the Injured Pediatric Athlete: Upper Extremity. Radiographics 2016; 36:1672-1687. [DOI: 10.1148/rg.2016160036] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Normal skeletal development and imaging pitfalls of the calcaneal apophysis: MRI features. Skeletal Radiol 2016; 45:483-93. [PMID: 26748646 DOI: 10.1007/s00256-015-2320-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 11/04/2015] [Accepted: 12/22/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Heel pain in children and secondary MR imaging (MRI) of the hindfoot have been increasing in incidence. Our purpose is to illustrate the, previously unreported, MRI stages in development of the posterior calcaneal apophysis, with attention to imaging pitfalls. This should aid in distinguishing normal growth from true disease. MATERIAL AND METHODS Consecutive ankle MRIs in children <18 years, from 2008-2014, were subdivided into 0≤5, 5≤10, 10≤15 and 15≤18 age groups and retrospectively reviewed for development of the calcaneal apophysis. RESULTS 204 ankle MRI studies in 188 children were identified. 40 studies were excluded with final cohort of 164 studies in 154 patients (82 boys, 72 girls). The calcaneal apophysis was cartilaginous until age 5. Foci of decreased as well as increased signal were embedded in cartilage, prior to ossification. Early, secondary ossification centers appeared in plantar third of the apophysis in 100% of children by age 7. Increased T2 signal in the ossifications was seen in 30% of children. Apohyseal fusion began at 12 and was complete in 78% of 14≤15 year olds and in 88% of 15≤18 year olds. Curvilinear low signal in the ossification centers, paralleling, but distinguished from growth plate, and not be confused with fracture line, was common. CONCLUSION Development of the posterior calcaneus follows a unique sequence. Apophyseal fusion occurs earlier than reported in the literature. Familiarity with this maturation pattern, in particular the apophyseal increased T2 signal and the linear low signal paralleling the growth plate, will avoid misinterpreting it for pathology.
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Zember JS, Rosenberg ZS, Kwong S, Kothary SP, Bedoya MA. Normal Skeletal Maturation and Imaging Pitfalls in the Pediatric Shoulder. Radiographics 2015; 35:1108-22. [DOI: 10.1148/rg.2015140254] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Skeletal developmental patterns in the acromial process and distal clavicle as observed by MRI. Skeletal Radiol 2015; 44:207-15. [PMID: 25319561 DOI: 10.1007/s00256-014-2020-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 08/23/2014] [Accepted: 09/22/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To provide an MRI timeline of normal skeletal developmental patterns in the acromial process and distal clavicle in children up to 18 years of age. MATERIALS AND METHODS Retrospective review of all shoulder MRIs obtained at our institution between January 2003 and March 2012, in children up to age 18, was performed. When available, radiographs and CT scans for these children were also reviewed. The following variables of the distal acromion and clavicle, with attention to morphology and MRI signal, were assessed: (1) Chondro-osseous junction and (2) Development and fusion of the secondary ossification centers. RESULTS Ninety-eight children with 116 MR studies were identified from the data search. Of these, 13 patients were excluded and the final cohort included 85 children with 102 MRI studies. Forty-one of these patients also had shoulder radiographs. The cartilaginous precursors of the distal clavicle and acromion conformed to the final shape of these structures. The chondro-osseous interphases became progressively more lobulated and notched in the distal acromion and clavicle respectively. Appearance and fusion of the secondary ossification centers was significantly earlier in our study than previously reported. Acromial secondary ossification centers began forming at age 10 and clavicular ones, while uncommon, began forming at age 11. Fusion of acromial primary and secondary ossification centers began at age 14 and was generally complete after age 16. CONCLUSIONS Based on MR imaging the development and fusion of the acromion and distal clavicle in children occur earlier than previously reported. They follow a sequential pattern and can serve as a blueprint for evaluating imaging studies of pediatric shoulders.
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Kothary S, Rosenberg ZS, Poncinelli LL, Kwong S. Skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population: MRI features. Skeletal Radiol 2014; 43:1281-8. [PMID: 24986651 DOI: 10.1007/s00256-014-1936-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 05/27/2014] [Accepted: 06/01/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the MRI appearance of normal skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population. To the best of our knowledge, this has not yet been studied in detail in the literature. MATERIALS AND METHODS An IRB-approved, HIPAA-compliant retrospective review of 105 consecutive shoulder MRI studies in children, ages 2 months to 18 years was performed. The morphology, MR signal, and development of the following were assessed: (1) scapular-coracoid bipolar growth plate, (2) glenoid and glenoid-coracoid interface secondary ossification centers, (3) glenoid advancing osseous surface. RESULTS The glenoid and glenoid-coracoid interface were identified in infancy as a contiguous, cartilaginous mass. A subcoracoid secondary ossification center in the superior glenoid was identified and fused in all by age 12 and 16, respectively. In ten studies, additional secondary ossification centers were identified in the inferior two-thirds of the glenoid. The initial concavity of the glenoid osseous surface gradually transformed to convexity, matching the convex glenoid articular surface. The glenoid growth plate fused by 16 years of age. Our study, based on MRI, demonstrated a similar pattern of development of the glenoid and glenoid coracoid interface to previously reported anatomic and radiographic studies, except for an earlier development and fusion of the secondary ossification centers of the inferior glenoid. CONCLUSIONS The pattern of skeletal development of the glenoid and glenoid-coracoid interface follows a chronological order, which can serve as a guideline when interpreting MRI studies in children.
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Affiliation(s)
- Shefali Kothary
- Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY, 10003, USA,
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Skeletal Development of the Proximal Humerus in the Pediatric Population: MRI Features. AJR Am J Roentgenol 2014; 202:418-25. [DOI: 10.2214/ajr.13.10711] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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