Current concepts in pediatric musculoskeletal imaging: magnetic resonance imaging

Abstract

Purpose of review The cartilaginous structures at the ends of growing bones of the immature skeleton are best seen with magnetic resonance imaging. Technologic advances in pediatric musculoskeletal magnetic resonance imaging have led to the development of advances in coil design with improved spatial resolution of both large and small joints. New sequences and higher field strengths now provide new insights into articular cartilage abnormalities. Recent findings The imaging of articular abnormalities in children includes those that affect the synovium, epiphyseal cartilage, and growth plate. Magnetic resonance imaging provides important information in the diagnosis of pediatric musculoskeletal trauma and the management of growth disturbances. Magnetic resonance imaging is now evolving as a tool to manage and monitor injuries that result in juvenile osteochondritis dissecans. Magnetic resonance classification of osteochondral injuries is helping to guide therapy with respect to nonsurgical management of juvenile osteochondritis dissecans. New magnetic resonance sequences are increasing our understanding of the structural changes of cartilage and could be used to monitor children with juvenile rheumatoid arthritis. Summary Understanding the technologic advances in pediatric musculoskeletal magnetic resonance imaging will make it easier to identify the cartilaginous structures of the immature skeleton and common abnormalities. New magnetic resonance imaging techniques are improving the resolution of subtle abnormalities of the cartilaginous structures, permitting earlier detection of abnormalities that may result in growth disturbances or articular cartilage injury. Magnetic resonance imaging techniques from ongoing research in adults are now being applied to, and have validated current research in, the cartilaginous changes in juvenile rheumatoid arthritis. These new advances in pediatric musculoskeletal magnetic resonance imaging are providing reproducible information of the cartilaginous structures and cartilage content of the immature skeleton and changes resulting from cartilage loss.