Abstract
a t a s p t l During the past 2 decades, there has been a substantial increase in the number of children and adolescents inolved in organized sports. The trend toward year-round raining and earlier involvement of children in highly cometitive sports before skeletal maturity increases the risk and everity of injury.1 Approximately 4.3 million recreational nd sports injuries occur each year in school-aged children in he United States,2 with approximately 3.5 million sportrelated injuries requiring medical treatment in children under the age of 15 years.3 Although some data suggest that oys are nearly twice as likely to suffer from athletic injuries, here has been a substantial increase in the number of girls nvolved in sports, and this has greatly increased the number f injuries they suffer, particularly in the knee. For boys, the ighest rates of injury per 1000 hours of exposure have been eported with ice hockey, rugby, and soccer, and for girls, ith soccer, basketball, and gymnastics.1 Specific injury patterns at each stage of development are determined by the sequential changes of the growing skeleton from childhood to adolescence along with the sportspecific mechanism of injury. Athletic injuries can be acute or may result from long standing overuse. Injuries from overuse may be confused with normal development-related changes in the skeleton. In pediatric patients, most injuries occur at the chondro-osseous junction, as this transition is the weakest link in the growing skeleton. During adolescence, rapid growth results in wider weaker physes, and increase in muscle strength outpaces the strength of bone and cartilage.4 This redisposes to avulsions at the insertions of muscles in the pophyses. Physeal injuries usually occur at the junction of etaphyseal bone and physeal cartilage at the zone of proviional calcification.5 This article will review the pathophysilogy, magnetic resonance imaging (MRI) characteristics, nd best imaging alternatives for the assessment and diagno-
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