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X-ray results
Is it possible for a new injury to show up on an xray looking like an old injury?
The doctors say it looks old and it must be from years ago but my daughter has never had any problems with her fibula before. (Although she did have a spiral fracture in her tibia twice)
She has had over 30 xrays in the last 18 monhts and there is nothing wrong with the fibula in any of them? Now the xray shows a salter harris fracture of fibula and malleolus.
Does it seem reasonable and likely that this did not show up on over 30 xrays??
Is there anything which will present as an old injury when it is actually a new one?
Thanks to anyone who can help!
The doctors say it looks old and it must be from years ago but my daughter has never had any problems with her fibula before. (Although she did have a spiral fracture in her tibia twice)
She has had over 30 xrays in the last 18 monhts and there is nothing wrong with the fibula in any of them? Now the xray shows a salter harris fracture of fibula and malleolus.
Does it seem reasonable and likely that this did not show up on over 30 xrays??
Is there anything which will present as an old injury when it is actually a new one?
Thanks to anyone who can help!
Hi Blayz Moon,
What a lovely name.
I think it’s a nice idea that she wants to become a doctor and specialize in pediatrics and grow as Pediatric Orthopaedician.
May god make her wish come true.
I wish her all the best for all her future endeavors.
I think your doubt regarding ossification center is clear. I would be really worried if she has any asymmetrical growth.
We should ask for early intervention if we feel there is gross deformity in her leg and her gait while walking is compromised.
You should be aware of the need to bring the child for 6 to12-month follow-up of Salter-Harris classification III or IV fracture or any fracture of distal femur or proximal tibia.
Keep me posted regarding her health in general.
Also keep me informed regarding her orthopedic concerns.
I wish her the best in the world.
Bye.
What a lovely name.
I think it’s a nice idea that she wants to become a doctor and specialize in pediatrics and grow as Pediatric Orthopaedician.
May god make her wish come true.
I wish her all the best for all her future endeavors.
I think your doubt regarding ossification center is clear. I would be really worried if she has any asymmetrical growth.
We should ask for early intervention if we feel there is gross deformity in her leg and her gait while walking is compromised.
You should be aware of the need to bring the child for 6 to12-month follow-up of Salter-Harris classification III or IV fracture or any fracture of distal femur or proximal tibia.
Keep me posted regarding her health in general.
Also keep me informed regarding her orthopedic concerns.
I wish her the best in the world.
Bye.
Hi,
Her name is Blayz Moon, hence my name on here, and everywhere else i need a screen name. She is very intelligent, and wants to be a pediatritian specializing in orthopedics whe she is older. She has always wanted to be pediatritian, even when she was only 2 years old, but now she wants to have a specialty. She is top her class, even though she is a year younger than the other children. She is my only child and my whole world.
Thanks again for all your help and i'll keep you posted wth updates as we get them.
Her name is Blayz Moon, hence my name on here, and everywhere else i need a screen name. She is very intelligent, and wants to be a pediatritian specializing in orthopedics whe she is older. She has always wanted to be pediatritian, even when she was only 2 years old, but now she wants to have a specialty. She is top her class, even though she is a year younger than the other children. She is my only child and my whole world.
Thanks again for all your help and i'll keep you posted wth updates as we get them.
Hi,
It is nice to see that you are concerned for your child and seeking information which can help her in any way.
What she meant by her finding is that there is an incidental finding on your daughters x-ray saying at the lower end of tibia there is a line of demarcation suggesting no further growth of bone in that part. There are two ossification center in long bones, primary ossification centre in diaphysis and secondary ossification centre in epiphyses.
The place where bone formation happens is called ossification center. It is important; as this is the place where from growth will be consistent.
I think your doctor is right for being concerned about asymmetrical growth as this can cause more deformity to child than any growth.
Keep me posted about her improvement in her ailment.
Tell my hi to her and lots of love.
What is her name?
Bye.
It is nice to see that you are concerned for your child and seeking information which can help her in any way.
What she meant by her finding is that there is an incidental finding on your daughters x-ray saying at the lower end of tibia there is a line of demarcation suggesting no further growth of bone in that part. There are two ossification center in long bones, primary ossification centre in diaphysis and secondary ossification centre in epiphyses.
The place where bone formation happens is called ossification center. It is important; as this is the place where from growth will be consistent.
I think your doctor is right for being concerned about asymmetrical growth as this can cause more deformity to child than any growth.
Keep me posted about her improvement in her ailment.
Tell my hi to her and lots of love.
What is her name?
Bye.
Hi,
It is nice to see that you are concerned for your child and seeking information which can help her in any way.
What she meant by her finding is that there is an incidental finding on your daughters x-ray saying at the lower end of tibia there is a line of demarcation suggesting no further growth of bone in that part. There are two ossification center in long bones, primary ossification centre in diaphysis and secondary ossification centre in epiphyses.
The place where bone formation happens is called ossification center. It is important; as this is the place where from growth will be consistent.
I think your doctor is right for being concerned about asymmetrical growth as this can cause more deformity to child than any growth.
Keep me posted about her improvement in her ailment.
Tell my hi to her and lots of love.
What is her name?
Bye.
It is nice to see that you are concerned for your child and seeking information which can help her in any way.
What she meant by her finding is that there is an incidental finding on your daughters x-ray saying at the lower end of tibia there is a line of demarcation suggesting no further growth of bone in that part. There are two ossification center in long bones, primary ossification centre in diaphysis and secondary ossification centre in epiphyses.
The place where bone formation happens is called ossification center. It is important; as this is the place where from growth will be consistent.
I think your doctor is right for being concerned about asymmetrical growth as this can cause more deformity to child than any growth.
Keep me posted about her improvement in her ailment.
Tell my hi to her and lots of love.
What is her name?
Bye.
Hi,
Thanks again for all your helpful information. The specialist my daughter seen on Wednesday specialized in pediatrics and foot and ankle. He is the one i went to for a second opinion. He is the one who said he will do nothing until he has another xray to compare the differences in 6 months time. You mentioned something called growth arrest, i recalled reading that in her notes so i had a check back and it said 'Incidental note is again made of a growth arrest line over the distal tibial metaphysis.' This note is from one of her visits on 24 September. They said 'again noted' so i looked further back and on her visit dated 26 March it says 'Growth arrest lines incidentally noted of distal tibial metaphysis.' You mentioned growth arrest where the growth plate stops growing, but what do growth arrest lines mean? Also, upon reading over her notes i found another item which i did not understand and has never been explained to me, can you tell me what it means please? It says 'There is a small bony density noted next to the tip of the medial malleolus which could be due to a secondary ossification center' What is an ossification center? and is this of any importance? I am located in North Carolina. To note, my daughter does not often complain of any pain, except at her achilles tendon. My daughter is 48 inches/4 foot tall right now. She is 6 years and almost 3 months old. (D.O.B. 09/30/01) The xrays taken by the pediatric ortho showed that her knee on one leg is higher than the knee of the other leg. The pediatric ortho seemed more conerned with the asymmetrical growth and the possible twisting of her tibia growth due to the length of the original tibial spiral fracture. He did not appear to be overly concerned about her growth plates. Again, many many thanks for all your help and knowledge.
Thanks again for all your helpful information. The specialist my daughter seen on Wednesday specialized in pediatrics and foot and ankle. He is the one i went to for a second opinion. He is the one who said he will do nothing until he has another xray to compare the differences in 6 months time. You mentioned something called growth arrest, i recalled reading that in her notes so i had a check back and it said 'Incidental note is again made of a growth arrest line over the distal tibial metaphysis.' This note is from one of her visits on 24 September. They said 'again noted' so i looked further back and on her visit dated 26 March it says 'Growth arrest lines incidentally noted of distal tibial metaphysis.' You mentioned growth arrest where the growth plate stops growing, but what do growth arrest lines mean? Also, upon reading over her notes i found another item which i did not understand and has never been explained to me, can you tell me what it means please? It says 'There is a small bony density noted next to the tip of the medial malleolus which could be due to a secondary ossification center' What is an ossification center? and is this of any importance? I am located in North Carolina. To note, my daughter does not often complain of any pain, except at her achilles tendon. My daughter is 48 inches/4 foot tall right now. She is 6 years and almost 3 months old. (D.O.B. 09/30/01) The xrays taken by the pediatric ortho showed that her knee on one leg is higher than the knee of the other leg. The pediatric ortho seemed more conerned with the asymmetrical growth and the possible twisting of her tibia growth due to the length of the original tibial spiral fracture. He did not appear to be overly concerned about her growth plates. Again, many many thanks for all your help and knowledge.
Hi blazymoon,
You have not shown your daughter to a Pediatric orthopaedician. I think you should take time off and make sure your daughter sees a Pediatric Orthopaedician. Your child is only 6 years old and has got whole life to live, if not taken care now; this might affect her whole life.
As of now I think pain medication can be used if compartment syndrome is not a concern.
As I told you earlier most growth plate fractures heal without difficulty. The higher the Salter-Harris classification, the more common is the incidence of growth abnormality.
If the patient is younger in skeletal maturity, the more would be growth abnormality. Anatomically, certain regions (e.g., distal tibia and distal femur) are more prone to growth disturbance and other regions (e.g., distal radius and proximal humerus) are relatively protected from growth disturbance.
Complications which can be noted are Growth arrest (growth plate stops growing) , Malunion, Growth disturbance (growth plate grows abnormally with resultant angulations), a more serious complication than growth acceleration.
Growth acceleration may occur which is due to increased blood flow for healing, which may occur in any child <10 years old with a fracture, and which usually amounts to only 5 to 10 mm.
Patient monitoring should be in place. Patients with growth-plate injuries are at increased risk of growth disturbance (Salter-Harris types III to V and all distal femur and distal tibial growth plate injuries) should be followed for at least 6 to 12 months to ensure normal growth.
At that time, the orthopaedician should:
Look for equality of limb length and angulations.
Look for the presence of a clean growth-plate line on a radiograph.
Look for the any growth-arrest lines of bone that was formed at the time of injury to be separated from the growth plate by an even layer of normal newly formed bone.
Which parts of US are you placed now?
I think you should take time off and show your child to a Pediatric Orthopaedician.
Alternatively, making her stand erect and you can check her height and individual limb lengths. What is her height now?
Bye.
You have not shown your daughter to a Pediatric orthopaedician. I think you should take time off and make sure your daughter sees a Pediatric Orthopaedician. Your child is only 6 years old and has got whole life to live, if not taken care now; this might affect her whole life.
As of now I think pain medication can be used if compartment syndrome is not a concern.
As I told you earlier most growth plate fractures heal without difficulty. The higher the Salter-Harris classification, the more common is the incidence of growth abnormality.
If the patient is younger in skeletal maturity, the more would be growth abnormality. Anatomically, certain regions (e.g., distal tibia and distal femur) are more prone to growth disturbance and other regions (e.g., distal radius and proximal humerus) are relatively protected from growth disturbance.
Complications which can be noted are Growth arrest (growth plate stops growing) , Malunion, Growth disturbance (growth plate grows abnormally with resultant angulations), a more serious complication than growth acceleration.
Growth acceleration may occur which is due to increased blood flow for healing, which may occur in any child <10 years old with a fracture, and which usually amounts to only 5 to 10 mm.
Patient monitoring should be in place. Patients with growth-plate injuries are at increased risk of growth disturbance (Salter-Harris types III to V and all distal femur and distal tibial growth plate injuries) should be followed for at least 6 to 12 months to ensure normal growth.
At that time, the orthopaedician should:
Look for equality of limb length and angulations.
Look for the presence of a clean growth-plate line on a radiograph.
Look for the any growth-arrest lines of bone that was formed at the time of injury to be separated from the growth plate by an even layer of normal newly formed bone.
Which parts of US are you placed now?
I think you should take time off and show your child to a Pediatric Orthopaedician.
Alternatively, making her stand erect and you can check her height and individual limb lengths. What is her height now?
Bye.
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