Salter-Harris IV Injury
HIDEInteractive Transcript
0:01
Okay, so I want to show you the
0:03
final of the Salter-Harris injuries.
0:05
We're not going to do Salter-Harris
0:06
5, uh, but that's a crush injury.
0:08
This is going to be a Salter-Harris Type IV injury.
0:11
And again, we're bringing you back to the knee.
0:14
Skeletally immature patient.
0:16
The image on your left is a fat
0:18
suppressed fluid-sensitive sequence.
0:20
The middle is a T1-weighted sequence.
0:22
And the right is my favorite
0:25
dual echo steady state.
0:26
So, if you take a look at this, you notice that
0:29
there's a lot of edema involving the epiphysis,
0:32
involving the growth plate on the, on the, uh,
0:35
lateral side, and also the metaphysis here.
0:39
On the T1-weighted sequence, in the
0:41
corresponding areas, you see areas of
0:43
decreased signal corresponding to edema.
0:46
And on the dual echo steady state sequence,
0:49
we in fact see a beautiful example of
0:52
cortical separation here at the epiphysis.
0:55
Fracture going through the epiphysis proper.
0:58
Look how wide that growth plate is
1:01
on this side versus the other side.
1:03
So we know indeed that this area is involved.
1:06
And finally, we can see a little
1:07
piece of bone over here in the
1:09
metaphysis that has flecked off.
1:11
So we know the fracture line extends this way,
1:15
goes up vertically into the joint space through
1:18
the epiphysis, and exits inferiorly through
1:21
the metaphysis into the adjacent periosteum.
1:24
So, this is a great example of a
1:26
Salter-Harris Type IV injury.
1:28
Um, again, because it's happening in the
1:30
knee, because it's Salter-Harris Type IV, the
1:33
likelihood of this forming into a FICL bar
1:36
or, um, growth disturbance is going to be
1:39
higher than had it been elsewhere or had it
1:42
been a lower grade of 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
© 2024 MRI Online. All Rights Reserved.