Salter-Harris I Injury
HIDEInteractive Transcript
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Okay, our prior vignette, we sort of drew cartoon
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diagrams and talked about the significance
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of Salter-Harris injuries, where we talked
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about what the different classifications
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are, the importance of the body part that's
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involved, and the difference between a
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horizontal and a longitudinal or vertically
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oriented or classified, uh, physeal injury.
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I want to start out with the most basic
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one, which is actually pretty uncommon.
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Uh, and that is Salter-Harris Type I injury,
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meaning that it involves only the physis.
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And it's very difficult to appreciate because
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there may just be a slight separation.
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The ankle is a good place to look because
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you have other physes there for comparison.
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For example, here's an injury to a patient
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on the lateral side, and you see on the
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coronal fat-suppressed fluid-sensitive
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sequence, there's a little bit of bright
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signal in the very lateral aspect
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of that distal fibular physis.
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Compare it to the physeal size and
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appearance of the distal tibia.
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The image on your right is the same
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patient with contrast administered.
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The reason that contrast was administered is
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because we weren't sure what the pain was from.
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So only after the MRI did we realize that it
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was from a Salter-Harris injury and eliciting
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more, more, more history from the patient.
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So again, here is the normal physis
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on the distal tibia, and here is the
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abnormal physis showing separation.
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But not involving the
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metaphysis or the epiphysis.
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So this is a Salter-Harris Type I injury.
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It's still at risk for bony bridge
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formation, but much less so than if it
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was a higher-grade Salter-Harris injury.
Mahesh Thapa, MD, MEd, FAAP
Division Chief of Musculoskeletal Imaging, and Director of Diagnostic Imaging Professor
Seattle Children's & University of Washington
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