Abstract
Focal periphyseal edema (FOPE) is a recently described condition seen on Magnetic Resonance Imaging (MRI) scans of adolescent patients in relation to knee pain. Since its description in 2011, and proposal as a possible reason for adolescent knee pain, few case series have been published. We report a case of an adolescent male with activity-related knee pain and FOPE finding on MRI scan of his knee. On reviewing medical literature we found nine case series reported with regards to FOPE zone. We have reviewed the demographic and clinical characteristics of the reported cases. With this report we aim to bring more awareness about this condition amongst orthopedic surgeons.
Highlights
In 2011 Zbojniewicz and Laor[1] described a distinct Magnetic Resonance Imaging (MRI) finding characterized by a focal bone marrow edema pattern centered at the physis of bones around the knee of adolescent patients
We report a case of an adolescent male with activity-related knee pain and focal periphyseal edema (FOPE) finding on MRI scan of his knee
We present a case with a FOPE zone finding on MRI scan in an adolescent male and reviewed published reports to find out what we know about this condition so far
Summary
In 2011 Zbojniewicz and Laor[1] described a distinct MRI finding characterized by a focal bone marrow edema pattern centered at the physis of bones around the knee of adolescent patients. The edema pattern extended to the adjacent metaphysis and epiphysis They coined this finding focal peripheral edema (FOPE) zones, and proposed that it could be a manifestation of normal physeal fusion, but could be a cause of adolescent knee pain when no other MRI abnormalities are present. He had never noticed any swelling in the knee He was unable to locate the pain but described it as deep seated. With no other lesions detected on the MRI scan we attributed his knee pain to the FOPE lesion The child and his parents were advised about the nature of the condition and he was recommended to cut down on sports activities and take mild analgesics when needed. On a phone call follow-up six months later, he reported less frequent pain, probably from not doing as much sports due to the Covid-19 pandemic restrictions
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