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Physeal injury in a skeletally immature male athlete
  1. Bradley Richey1 and
  2. Cassidy M Foley Davelaar1,2
  1. 1University of Central Florida College of Medicine, Orlando, Florida, USA
  2. 2Orthopaedics, Nemours Children's Hospital, Orlando, Florida, USA
  1. Correspondence to Dr Cassidy M Foley Davelaar; Cassidy.Foley{at}


A 12-year-old skeletally immature male athlete presented for evaluation with acute bilateral knee pain. Initial radiographs revealed subtle lucency of the medial proximal tibial physis and MRI was recommended. On MRI, broad-based intravasation of the physis into the proximal femoral and tibial physes was observed. This represented physeal widening, a phenomenon that has been observed in skeletally immature athletes presenting for acute knee pain. While such changes to the physis may be quite prominent on MRI, conventional radiographic findings may be much more subtle. As many causes of chronic knee pain in this population are managed with active rehabilitation, a high index of suspicion for this diagnosis in the presence of physeal abnormalities may warrant evaluation with MRI. The literature suggests this pathology will resolve with rest, but, if weight-bearing activities are continued, there is a risk for significant growth abnormalities.

  • orthopaedics
  • paediatrics
  • sports and exercise medicine
  • knee injuries
  • physiotherapy (sports medicine)

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  • Contributors BR contributed to conception and design, collection of case report material, interpretation of data, primary drafting of manuscript, and revision of manuscript. CMFD contributed to conception and design, collection of case report material, interpretation of data, drafting of manuscript, and revision of manuscript. Both authors agree to be accountable for the article and give final approval of the version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.