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Pediatric Radiology

16-03-2024 | Magnetic Resonance Imaging | Pictorial Essay

Pictorial review: challenges in distinguishing bilateral metaphyseal marrow abnormalities on magnetic resonance imaging

Authors: Sean M Booth, Tejas H Kapadia, Vivian Tang, Amit F Maniyar

Published in: Pediatric Radiology

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Abstract

The paediatric metaphysis is afflicted by a wide range of pathological processes as it is the most metabolically active and well-vascularised part of the developing skeleton. This review focuses on metaphyseal marrow signal change detected with magnetic resonance imaging, which is most often occult on radiographs. When bilateral, these imaging appearances frequently present a diagnostic quandary. This review assists the radiologist to confidently dismiss physiological signal change and confidently work through the differential diagnosis. This is achieved by illustrating a practical method of classifying signal change into four categories: physiological red marrow, red marrow reconversion, marrow infiltration, and oedema-like marrow signal intensity. In doing so, various pathological entities are reviewed along with imaging pearls and next-step investigations.

Graphical abstract

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Metadata
Title
Pictorial review: challenges in distinguishing bilateral metaphyseal marrow abnormalities on magnetic resonance imaging
Authors
Sean M Booth
Tejas H Kapadia
Vivian Tang
Amit F Maniyar
Publication date
16-03-2024
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-024-05896-7