By Alan Emil Oestreich
This booklet is an equipped method of knowing bone progress and sickness. It integrates anatomic and radiologic wisdom of enchondral and membranous bone development and emphasizes the similarities of the physis and acrophysis in improvement. The art, together produced through artist and writer, illustrates the thoughts defined. The identity of abnormality is aided by means of the reasons of the reasons by way of trend recognition.
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Extra info for Growth of the Pediatric Skeleton: A Primer for Radiologists
Sample text
The ZPC remains of normal density. The equivalent pattern seen in the vertebral column of infants after 10 days is the “bone-in-bone” pattern: the vertebral end plates, which are ZPCs, maintain normal density and the prenatal bone is of “normal” bone density; however, postnatal bone in-between is relatively demineralized. Consequently, the normal prenatal bone appears as apparently dense bone within a bone. The same pattern appears in such enchondral bone centers as calcaneus and talus. Later in the first year of life, those metaphyseal lucent bands are no longer seen.
Abuse fractures may simulate those seen in osteoporosis, but are secondary to abnormal trauma rather than abnormal bone. One should always also consider non-abuse causes of the fractures, including osteogenesis imperfecta. Menkes syndrome (in boys), and leukemia. 8 Chapter 8 ■ Dysplasias and Dysostoses Dysplasias and Dysostoses Several dichotomies are fundamental in consideration of the patterns of abnormal growth known as dysplasias and dysostoses: systematic vs. , chance distribution of abnormalities] conditions; slowed vs.
That cap closely resembles a conventional growth plate (Fig. 16). To emphasize that resemblance, I call the growth plate of the cartilage cap, “paraphysis” [para = alongside, from the Greek]. This paraphysis is subject to all the vagaries of the physis and acrophysis in cases of generalized abnormality. If ever you see a subject with exostosis who has rickets, I predict the loss of its ZPC and I would appreciate seeing the example. Growth of the exostosis from its paraphysis continues until the end of enchondral growth in adolescence.