Skip to main content
SpringerLink
Log in

MRI evaluation of the knee in children with infantile Blount disease: tibial and extra-tibial findings

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

An Erratum to this article was published on 28 May 2013

Abstract

Background

Infantile Blount disease is a developmental condition characterized by disorganized endochondral ossification in the medial aspect of the proximal tibial physis.

Objective

To describe the MR imaging abnormalities in the proximal tibia, distal femur, menisci and ligaments of children with infantile Blount disease.

Materials and methods

We retrospectively evaluated 11 children (18 total knee MR examinations) with infantile Blount disease and compared them with an age-matched control group with normal MR examinations. Morphological and morphometric measurements were performed.

Results

The medial menisci were enlarged with increased T2 signal intensity in all MR examinations. The medial femoral epiphyseal cartilage showed abnormal foci of increased signal intensity in nine (50%). The mid-coronal thickness of the medial tibial epiphyseal cartilage was decreased with concomitant increase in the mid-coronal joint space distance. Angular measurements of the proximal tibia demonstrated posteromedial down-sloping configuration.

Conclusions

Most severe abnormalities of infantile Blount disease occur in the medial compartment of the knee, especially at the medial tibial physis and epiphysis. However, other important structures of the knee and the lateral compartment are often affected. MR imaging helps to delineate the extent of multiple tibial and extra-tibial abnormalities, including meniscal abnormalities, perichondrial membrane changes and premature physeal closure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Ducou le Pointe H, Mousselard H, Rudelli A et al (1995) Blount’s disease: magnetic resonance imaging. Pediatr Radiol 25:12–14

    Article  PubMed  CAS  Google Scholar 

  2. Blount WP (1966) Tibia vara, osteochondrosis deformans tibiae. Curr Pract Orthop Surg 3:141–156

    PubMed  CAS  Google Scholar 

  3. Sabharwal S (2009) Blount disease. J Bone Joint Surg Am 91:1758–1776

    Article  PubMed  Google Scholar 

  4. Sabharwal S, Lee J Jr, Zhao C (2007) Multiplanar deformity analysis of untreated Blount disease. J Pediatr Orthop 27:260–265

    Article  PubMed  Google Scholar 

  5. Cheema JI, Grissom LE, Harcke HT (2003) Radiographic characteristics of lower-extremity bowing in children. Radiographics 23:871–880

    Article  PubMed  Google Scholar 

  6. Cook SD, Lavernia CJ, Burke SW et al (1983) A biomechanical analysis of the etiology of tibia vara. J Pediatr Orthop 3:449–454

    Article  PubMed  CAS  Google Scholar 

  7. Davids JR, Huskamp M, Bagley AM (1996) A dynamic biomechanical analysis of the etiology of adolescent tibia vara. J Pediatr Orthop 16:461–468

    Article  PubMed  CAS  Google Scholar 

  8. Sabharwal S, Zhao C, McClemens E (2007) Correlation of body mass index and radiographic deformities in children with Blount disease. J Bone Joint Surg Am 89:1275–1283

    Article  PubMed  Google Scholar 

  9. Hofmann A, Jones RE, Herring JA (1982) Blount’s disease after skeletal maturity. J Bone Joint Surg Am 64:1004–1009

    PubMed  CAS  Google Scholar 

  10. Zayer M (1980) Osteoarthritis following Blount’s disease. Int Orthop 4:63–66

    Article  PubMed  CAS  Google Scholar 

  11. Langenskiöld A (1981) Tibia vara: osteochondrosis deformans tibiae. Blount’s disease. Clin Orthop Relat Res 158:77–82

    PubMed  Google Scholar 

  12. Catonne Y, Pacault C, Azaloux H et al (1980) Radiological appearances in Blount’s disease. J Radiol 61:171–176

    PubMed  CAS  Google Scholar 

  13. Johnston CE 2nd (1990) Infantile tibia vara. Clin Orthop Relat Res 255:13–23

    PubMed  Google Scholar 

  14. Thompson GH, Carter JR (1990) Late-onset tibia vara (Blount’s disease). Current concepts. Clin Orthop Relat Res 255:24–35

    PubMed  Google Scholar 

  15. Stanitski DF, Stanitski CL, Trumble S (1999) Depression of the medial tibial plateau in early-onset Blount disease: myth or reality? J Pediatr Orthop 19:265–269

    PubMed  CAS  Google Scholar 

  16. Guermazi A, Mohr A, Henry P et al (2003) Does Blount disease alter the growth of the distal femur? AJR Am J Roentgenol 180:282–283, author reply 283–284

    Article  PubMed  Google Scholar 

  17. Ecklund K, Jaramillo D (2002) Patterns of premature physeal arrest: MR imaging of 111 children. AJR Am J Roentgenol 178:967–972

    Article  PubMed  Google Scholar 

  18. Synder M, Vera J, Harcke HT et al (2003) Magnetic resonance imaging of the growth plate in late-onset tibia vara. Int Orthop 27:217–222

    Article  PubMed  Google Scholar 

  19. Craig JG, van Holsbeeck M, Zaltz I (2002) The utility of MR in assessing Blount disease. Skeletal Radiol 31:208–213

    Article  PubMed  Google Scholar 

  20. Arai K, Haga N, Taniguchi K et al (2001) Magnetic resonance imaging findings and treatment outcome in late-onset tibia vara. J Pediatr Orthop 21:808–811

    PubMed  CAS  Google Scholar 

  21. Sabharwal S, Wenokor C, Mehta A et al (2012) Intra-articular morphology of the knee joint in children with Blount disease: a case–control study using MRI. J Bone Joint Surg Am 94:883–890

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Radiology, The Children’s Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Victor Ho-Fung, Camilo Jaimes, Joege Delgado & Diego Jaramillo

  2. Department of Radiology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Victor Ho-Fung & Diego Jaramillo

  3. Department of Orthopedic Surgery, The Children’s Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, USA

    Richard S. Davidson

  4. Department of Orthopedic Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Richard S. Davidson

Authors
  1. Victor Ho-Fung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Camilo Jaimes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joege Delgado
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Richard S. Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Diego Jaramillo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Victor Ho-Fung.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ho-Fung, V., Jaimes, C., Delgado, J. et al. MRI evaluation of the knee in children with infantile Blount disease: tibial and extra-tibial findings. Pediatr Radiol 43, 1316–1326 (2013). https://doi.org/10.1007/s00247-013-2686-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-013-2686-1

Keywords

Search

Navigation