Abstract
BackgroundGrowth arrest lines can develop within the skeleton after physiological stress or trauma. They are usually evident on radiographs as transverse lines in the metaphyses and have been used in fields from palaeontology to orthopaedics. This report consists of three cases, two of which describe growth arrest lines in an intra-epiphyseal site hitherto rarely documented, and a third demonstrating their clinical application.Case presentationCase 1 describes a 9-year-old who suffered a knee hyperflexion injury requiring anterior cruciate ligament and posterior cruciate ligament reattachments. She subsequently developed a marked distal femoral intra-epiphyseal arrest silhouette, as well as metaphyseal arrest lines in the femur, tibia and fibula. Case 2 describes an 8-year-old who sustained a tibial spine fracture and underwent open reduction and internal fixation. Subsequent imaging shows a further example of femoral intra-epiphyseal arrest silhouette as well as tibia and fibula metaphyseal arrest lines. Case 3 describes a 10-year-old who sustained a distal tibia fracture which was managed with open reduction and internal fixation. Subsequently the metaphyseal growth arrest line was parallel to the physis, suggesting no growth arrest (a danger with such a fracture).ConclusionThis case series describes two examples of rarely described intra-epiphyseal growth arrest silhouettes and demonstrates the usefulness of arrest lines when assessing for growth plate damage.
Highlights
Growth arrest lines can develop within the skeleton after physiological stress or trauma
This case series describes two examples of rarely described intra-epiphyseal growth arrest silhouettes and demonstrates the usefulness of arrest lines when assessing for growth plate damage
Growth arrest lines occur at sites where there is a slowing of longitudinal bone growth, appearing as transverse metaphyseal lines on radiographs [1]
Summary
Growth arrest lines occur at sites where there is a slowing of longitudinal bone growth, appearing as transverse metaphyseal lines on radiographs [1]. They were first documented by Harris [2] in 1926 and have been utilised as a marker of disease in fields from palaeontology [3] to orthopaedics [4]. Case 2 This 8-year-old girl sustained a right-sided tibial spine fracture (Figure 3). Given its displacement, this required open reduction and internal fixation. Radiographs (Figure 6) demonstrate the arrest lines moving away over time in parallel from the physis, demonstrating the absence of growth arrest at this stage
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