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Salter-Harris I Injury

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0:01

Okay, our prior vignette, we sort of drew cartoon

0:04

diagrams and talked about the significance

0:07

of Salter-Harris injuries, where we talked

0:08

about what the different classifications

0:11

are, the importance of the body part that's

0:13

involved, and the difference between a

0:15

horizontal and a longitudinal or vertically

0:17

oriented or classified, uh, physeal injury.

0:21

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,

0:29

meaning that it involves only the physis.

0:32

And it's very difficult to appreciate because

0:34

there may just be a slight separation.

0:36

The ankle is a good place to look because

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you have other physes there for comparison.

0:42

For example, here's an injury to a patient

0:45

on the lateral side, and you see on the

0:47

coronal fat-suppressed fluid-sensitive

0:49

sequence, there's a little bit of bright

0:51

signal in the very lateral aspect

0:54

of that distal fibular physis.

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Compare it to the physeal size and

0:58

appearance of the distal tibia.

1:01

The image on your right is the same

1:02

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

1:11

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

1:18

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.

1:26

So this is a Salter-Harris Type I injury.

1:31

It's still at risk for bony bridge

1:34

formation, but much less so than if it

1:38

was a higher-grade Salter-Harris injury.

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

X-Ray (Plain Films)

Trauma

Pediatrics

Musculoskeletal (MSK)

MRI

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