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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
2 topics, 5 min.
38 topics, 2 hr. 9 min.
Introduction to Pediatric Imaging
2 m.Hyaline Cartilage Anatomy
3 m.The Physis & Calcification Centers
3 m.Epiphyseal Cartilage
4 m.Fibrocartilage & Hyaline Cartilage
6 m.MR Appearance of Cartilage In Different Age Groups
5 m.FOPE
4 m.Lymphoma of the Bone
12 m.Blount Disease
4 m.Gymnast’s Wrist
5 m.Pre-ossification Centers
3 m.Elbow Effusion
2 m.OCD In the Elbow
3 m.Trochlear OCD on MRI
2 m.Trochlear OCD on Arthrogram
2 m.Ultrasound Guided Arthrogram Injection
3 m.OCD In the Capitellum, Loose Body
3 m.Avascular Necrosis in the Elbow
3 m.The Fish Tail Deformity
4 m.OCD In the Knee, LAME
4 m.Legg-Calvé-Perthes disease on X-Ray
3 m.Legg-Calvé-Perthes disease on MRI
5 m.Juvenile Idiopathic Arthritis
4 m.Abscess
4 m.Infection in the Physis
3 m.Tug Lesion
7 m.Salter-Harris Classification System
5 m.Salter-Harris Fracture on X-Ray
3 m.Salter-Harris 2 in the Shoulder
3 m.Salter-Harris 3 in the Knee
3 m.Salter-Harris 3 on CT Imaging
3 m.Indications for MRI in a Pediatric Shoulder
4 m.Performing Arthrograms in the Shoulder
3 m.Ultrasound Guidance in Shoulder Arthrogram
3 m.Salter-Harris 5 on MRI
3 m.Physeal Injury, Cartilage Deformity
5 m.Chondroblastoma in the Knee
5 m.Chondroblastoma in the Ankle
5 m.9 topics, 41 min.
3 topics, 13 min.
3 topics, 12 min.
13 topics, 39 min.
Anorexia Nervosa
3 m.Chondroblastoma
4 m.Chondroblastoma in the Shoulder
4 m.Complex Regional Pain Syndrome
4 m.Lipoblastoma
4 m.Leukemia
4 m.Leukemia, Assessing for Asymmetry
4 m.Myositis Ossificans
3 m.Normal Patchy Bone Marrow
4 m.Osteoblastoma
4 m.Adamantinoma verus Osteofibrous Dysplasia
2 m.Osteoid Osteoma in the Foot
3 m.Osteoid Osteoma in the Finger
3 m.5 topics, 11 min.
0:00
Okay, now we've talked briefly about
0:03
the components of the epiphysis.
0:04
We talked about the articular cartilage, the
0:07
physeal cartilage, and the epiphyseal cartilage.
0:09
Now let's focus a little bit
0:10
on the physeal cartilage.
0:13
So again, we had our epiphysis, we had our
0:19
metaphysis, and we're going to concentrate
0:23
on this area right here, which is our physis.
0:27
So I'm going to get rid of this.
0:29
We're talking about just the physis now.
0:34
This is on the epiphyseal
0:36
side, and this is on the metaphyseal side.
0:42
I'm going to choose a little different color.
0:45
I'm going to make it red,
0:48
and I'm going to draw
0:52
this.
0:54
And I'm going to take yellow, and
0:56
just sort of fill in this part here,
1:02
and this part over here.
1:05
It's kind of pretty.
1:06
So, we said that this is the
1:08
metaphyseal side over here, and this
1:12
is the epiphyseal side over here.
1:14
What's drawn in yellow is going to
1:16
look like very, very bright signal
1:19
on T2 FATSAT or STIR imaging.
1:23
Uh, what's the red?
1:25
It's going to look
1:28
very dark on T2 or STIR.
1:34
Let me put that in yellow just so
1:35
you have for the sake of completion.
1:38
T2 STIR.
1:41
T2 STIR.
1:44
Right.
1:44
Bright, bright, dark.
1:46
T2 STIR.
1:46
So what are the dark areas
1:47
and what are the bright areas?
1:49
So the dark area is actually what's called
1:52
a zone of provisional calcification.
1:54
That's where cartilage, uh, is undergoing
1:57
calcification and turning into bone.
2:00
This bright area on the metaphyseal side
2:03
is what's called the spongiosa layer.
2:04
It's a very vascular area.
2:06
That's where you have a lot of capillaries that
2:09
release hematopoietic factors, humoral factors.
2:12
And because it's very vascular,
2:14
it's gonna appear bright
2:15
on STIR and T2 weighted images.
2:18
The second yellow, which is over here,
2:20
this is on the epiphyseal side, and this
2:24
is where you have these big, big cartilage
2:28
cells that are going to be undergoing
2:30
transformation and becoming bone.
2:33
Because the cartilage cells here are
2:35
so much bigger than the cartilage cells
2:37
up here, it has a lot of water in it.
2:39
And remember, we said water, that's
2:41
unbound, it's going to be bright on T2, and
2:43
that's what it's going to look like on T2.
2:46
images.
2:47
Now let's go to see what this looks like on MRI.
Interactive Transcript
0:00
Okay, now we've talked briefly about
0:03
the components of the epiphysis.
0:04
We talked about the articular cartilage, the
0:07
physeal cartilage, and the epiphyseal cartilage.
0:09
Now let's focus a little bit
0:10
on the physeal cartilage.
0:13
So again, we had our epiphysis, we had our
0:19
metaphysis, and we're going to concentrate
0:23
on this area right here, which is our physis.
0:27
So I'm going to get rid of this.
0:29
We're talking about just the physis now.
0:34
This is on the epiphyseal
0:36
side, and this is on the metaphyseal side.
0:42
I'm going to choose a little different color.
0:45
I'm going to make it red,
0:48
and I'm going to draw
0:52
this.
0:54
And I'm going to take yellow, and
0:56
just sort of fill in this part here,
1:02
and this part over here.
1:05
It's kind of pretty.
1:06
So, we said that this is the
1:08
metaphyseal side over here, and this
1:12
is the epiphyseal side over here.
1:14
What's drawn in yellow is going to
1:16
look like very, very bright signal
1:19
on T2 FATSAT or STIR imaging.
1:23
Uh, what's the red?
1:25
It's going to look
1:28
very dark on T2 or STIR.
1:34
Let me put that in yellow just so
1:35
you have for the sake of completion.
1:38
T2 STIR.
1:41
T2 STIR.
1:44
Right.
1:44
Bright, bright, dark.
1:46
T2 STIR.
1:46
So what are the dark areas
1:47
and what are the bright areas?
1:49
So the dark area is actually what's called
1:52
a zone of provisional calcification.
1:54
That's where cartilage, uh, is undergoing
1:57
calcification and turning into bone.
2:00
This bright area on the metaphyseal side
2:03
is what's called the spongiosa layer.
2:04
It's a very vascular area.
2:06
That's where you have a lot of capillaries that
2:09
release hematopoietic factors, humoral factors.
2:12
And because it's very vascular,
2:14
it's gonna appear bright
2:15
on STIR and T2 weighted images.
2:18
The second yellow, which is over here,
2:20
this is on the epiphyseal side, and this
2:24
is where you have these big, big cartilage
2:28
cells that are going to be undergoing
2:30
transformation and becoming bone.
2:33
Because the cartilage cells here are
2:35
so much bigger than the cartilage cells
2:37
up here, it has a lot of water in it.
2:39
And remember, we said water, that's
2:41
unbound, it's going to be bright on T2, and
2:43
that's what it's going to look like on T2.
2:46
images.
2:47
Now let's go to see what this looks like on MRI.
Report
Faculty
Mahesh Thapa, MD, MEd, FAAP
Division Chief of Musculoskeletal Imaging, and Director of Diagnostic Imaging Professor
Seattle Children's & University of Washington
Tags
Pediatrics
Neonatal
Musculoskeletal (MSK)
MRI
Congenital
Acquired/Developmental
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