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Joseph Junewick, MD FACR
over 7 years ago
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Marrow Fat in Periosteal New Bone after Fracture

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: CR MR
Activities:
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History

5 year old male, follow up distal radius fracture.


Case Images


Diagnosis

Marrow Fat in Periosteal New Bone after Fracture

Clinical Notes

No pain, fever or leukocytosis.

Findings

CR – Posteriorly impacted buckle fracture of the distal metaphysis of the radius with mature new bone; multifocal small round lucencies in the periosteal new bone.

MR – Lucencies correspond to hyperintensities on sagittal and axial T1 images which suppress on fat-saturated axial T1.

Discussion

Post-traumatic cortical defects are rare. Typically these are seen 6 weeks or later following a greenstick or torus fracture of the radius, although the supracondylar humerus and tibia can also be involved. Defects are subperiosteal or juxtacortical and proximal to the site of initial fracture. Blood and or fat are released from the medullary canal by compressive forces during the injury and collect under unbreached periosteum. Defects are non-expansile, migrate away from the physis with growth and undergo eventual ossification.

Reference

Roach RT, Cassar-Pullicino V, Summers BN. Paediatric post-traumatic cortical defects of the distal radius. Pediatr Radiol (2002); 32:333-339.



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