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Pediatric Radiology
Published in: Pediatric Radiology 12/2016

01-11-2016 | Original Article

Age- and gender-related characteristics of the pubic symphysis and triradiate cartilage in pediatric computed tomography

Authors: Jörg Bayer, Jakob Neubauer, Ulrich Saueressig, Norbert P Südkamp, Kilian Reising

Published in: Pediatric Radiology | Issue 12/2016

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Abstract

Background

There is little information on the pubic symphysis’ normal CT appearance in children.

Objective

We sought to generate age-, gender- and maturity-related symphyseal width appearances in CT scans.

Materials and methods

Pelvic CT scans performed for any reason during a 6-year period in patients younger than 18 years were retrospectively analyzed. The symphysis width was measured in the axial plane and the triradiate cartilage was classified as open or closed.

Results

Four hundred twenty-seven CT scans were evaluated and 350 remained for analysis. Age- and gender-related measurements of the symphysis width are illustrated on various centile graphs. When grouping children by age in years 0–6, 7–11, 12–15 and 16–17, mean (standard deviation) symphysis width was 5.4 mm (0.9), 5.3 mm (1.1), 4.1 mm (1.1) and 3.5 mm (1.0), respectively, in girls and 5.9 mm (1.3), 5.4 mm (1.2), 5.2 mm (1.1) and 4.0 mm (1.0), respectively, in boys. Boys and girls were significantly different in the age groups 12–15 years (P<0.001) and 16-17 years (P=0.04). In the mature pelvis, the symphyseal gap is significantly (P<0.001) shorter in both genders, and in girls compared to boys (P=0.04).

Conclusion

The pubic symphysis width in children differs according to age, gender and maturity. The reference values published herein may help detect symphyseal injury.
Literature
1.
Galano GJ, Vitale MA, Kessler MW et al (2005) The most frequent traumatic orthopaedic injuries from a national pediatric inpatient population. J Pediatr Orthop 25:39–44PubMed
2.
Spiguel L, Glynn L, Liu D et al (2006) Pediatric pelvic fractures: a marker for injury severity. Am Surg 72:481–484PubMed
3.
Demetriades D, Karaiskakis M, Velmahos GC et al (2003) Pelvic fractures in pediatric and adult trauma patients: are they different injuries? J Trauma 54:1146–1151CrossRefPubMed
4.
Keshishyan RA, Rozinov VM, Malakhov OA et al (1995) Pelvic polyfractures in children. Radiographic diagnosis and treatment. Clin Orthop Relat Res 320:28–33
5.
Gansslen A, Heidari N, Weinberg AM (2013) Fractures of the pelvis in children: a review of the literature. Eur J Orthop Surg Traumatol 23:847–861CrossRefPubMed
6.
Smith W, Shurnas P, Morgan S et al (2005) Clinical outcomes of unstable pelvic fractures in skeletally immature patients. J Bone Joint Surg Am 87:2423–2431CrossRefPubMed
7.
Banerjee S, Barry MJ, Paterson JM (2009) Paediatric pelvic fractures: 10 years experience in a trauma centre. Injury 40:410–413CrossRefPubMed
8.
Leonard M, Ibrahim M, Mckenna P et al (2011) Paediatric pelvic ring fractures and associated injuries. Injury 42:1027–1030CrossRefPubMed
9.
Silber JS, Flynn JM (2002) Changing patterns of pediatric pelvic fractures with skeletal maturation: implications for classification and management. J Pediatr Orthop 22:22–26PubMed
10.
Silber JS, Flynn JM, Koffler KM et al (2001) Analysis of the cause, classification, and associated injuries of 166 consecutive pediatric pelvic fractures. J Pediatr Orthop 21:446–450PubMed
11.
Eich GF, Babyn P, Giedion A (1992) Pediatric pelvis: radiographic appearance in various congenital disorders. Radiographics 12:467–484CrossRefPubMed
12.
Guillamondegui OD, Pryor JP, Gracias VH et al (2002) Pelvic radiography in blunt trauma resuscitation: a diminishing role. J Trauma 53:1043–1047CrossRefPubMed
13.
Chia JP, Holland AJ, Little D et al (2004) Pelvic fractures and associated injuries in children. J Trauma 56:83–88CrossRefPubMed
14.
Guillamondegui OD, Mahboubi S, Stafford PW et al (2003) The utility of the pelvic radiograph in the assessment of pediatric pelvic fractures. J Trauma 55:236–239CrossRefPubMed
15.
Lunsjo K, Tadros AM, Hauggaard A et al (2007) Acute plain anterioposterior radiograph of the pelvis is not useful in detecting fractures of iliac wing and os sacrum: a prospective study of 73 patients using CT as gold standard. Australas Radiol 51:147–149CrossRefPubMed
16.
Silber JS, Flynn JM, Katz MA et al (2001) Role of computed tomography in the classification and management of pediatric pelvic fractures. J Pediatr Orthop 21:148–151PubMed
17.
McAlister DM, Webb HR, Wheeler PD et al (2005) Pubic symphyseal width in pediatric patients. J Pediatr Orthop 25:725–727CrossRefPubMed
18.
19.
Nejad AH, Jamali A, Wootton-Gorges SL et al (2012) Symphysis pubis width in the pediatric population: a computerized tomography study. J Trauma Acute Care Surg 73:923–927CrossRefPubMed
20.
Bucholz RW, Ezaki M, Ogden JA (1982) Injury to the acetabular triradiate physeal cartilage. J Bone Joint Surg Am 64:600–609PubMed
21.
Liporace FA, Ong B, Mohaideen A et al (2003) Development and injury of the triradiate cartilage with its effects on acetabular development: review of the literature. J Trauma 54:1245–1249CrossRefPubMed
22.
Rigby RA, Stasinopoulos DM (2013) Automatic smoothing parameter selection in GAMLSS with an application to centile estimation. Stat Methods Med Res 23:318–332CrossRefPubMed
23.
Benjamini Y, Yekutieli D (2001) The control of the false discovery rate in multiple testing under dependency. Ann Stat 1165-1188
24.
Bayer J, Reising K, Kuminack K et al (2015) Is whole-body computed tomography the standard work-up for severely-injured children? Results of a survey among German Trauma Centers. Acta Chir Orthop Traumatol Cech 82: 332–336
25.
Muecke EC, Currarino G (1968) Congenital widening of the pubic symphysis: associated clinical disorders and roentgen anatomy of affected bony pelves. Am J Roentgenol Radium Ther Nucl Med 103:179–185CrossRefPubMed
26.
Weiner LS, Kelley MA, Ulin RI et al (1993) Development of the acetabulum and hip: computed tomography analysis of the axial plane. J Pediatr Orthop 13:421–425CrossRefPubMed
Metadata
Title
Age- and gender-related characteristics of the pubic symphysis and triradiate cartilage in pediatric computed tomography
Authors
Jörg Bayer
Jakob Neubauer
Ulrich Saueressig
Norbert P Südkamp
Kilian Reising
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 12/2016
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-016-3671-2

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