Malignant Mixed Germ Cell Tumor
Joseph Junewick, MD FACR
over 7 years ago
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Heather Borders, MD
|Diagnostic Category: Trauma
|Created: over 6 years ago
|Updated: over 6 years ago
13 year old male with wrist pain during gymnastics
Widening and irregularity of the distal radial physis. Cartilage invagination into the metaphysis. No significant marrow edema or soft tissue edema. Relative sparing of the distal ulna.
Gymnast wrist represents a chronic physeal stress injury. This is manifested on radiographs as physeal widening and metaphyseal irregularity. The radius is primarily involved as the ulna does not bear much of the loading forces.
Metaphyseal injury likely results in ischemia to the zone of hypertrophy, disruption of the ZPC and metaphyseal cartilage rests which contribute to the metaphyseal undulation and irregularity.
The changes may result in premature physeal closure, ulnar overgrowth and ulnar impaction syndrome or madelung type deformity.
Differential includes rickets, SH I injury.
Pediatric and adolescent MSK MRI: J Herman Kan.