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The acrophysis: a unifying concept for enchondral bone growth and its disorders. I. Normal growth

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Abstract

In order to discuss and illustrate the common effects on normal and abnormal enchondral bone at the physes and at all other growth plates of the developing child, the term "acrophysis" is proposed. Acrophyses include the growth plates of secondary growth centers including carpals and tarsals and apophyses, and the growth plates at the non-physeal ends of small tubular bones. The last layer of development of both physes and acrophysis is the cartilaginous zone of provisional calcification (ZPC). The enchondral bone abutting the ZPC shares similar properties at physes and acrophyses, including the relatively lucent metaphyseal bands of many normal infants at several weeks of age. The bone-in-bone pattern of the normal vertebral bodies and bands of demineralization of the tarsal bones just under the ZPC are the equivalent of those bands. The growth arrest/recovery lines of metaphyses similarly have equivalent lines in growth centers and other acrophyseal sites. Nearly the same effects can also be anticipated from the relatively similar growth plate at the cartilaginous cap of benign exostoses ("paraphysis"). The companion article will explore abnormalities at acrophyseal sites, including metabolic bone disease and dysplasias.

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References

  1. Oestreich AE, Ahmad BS. The periphysis and its effect on the metaphysis. I. Definition and normal radiographic pattern. Skeletal Radiol 1992; 21:283.

    CAS  PubMed  Google Scholar 

  2. Oestreich AE. Kindliche Arthrosen als Folge enchondraler Schädigung. [Pediatric arthroses as a sequela of enchondral damage.] Radiologe 2000; 40:1149–1153.

    Article  CAS  PubMed  Google Scholar 

  3. Rubin P. Dynamic classification of bone dysplasias. Chicago: Year Book, 1964:5.

  4. Gove PB, ed. Webster's third new international dictionary of the English language, unabridged. Springfield, MA: Merriam-Webster, 1986:19.

  5. Ogden JA. The development and growth of the musculoskeletal system. In: Albright JA, Brand RA, eds. The scientific basis of orthopaedics. New York: Appleton-Century-Crofts, 1979:41–103.

  6. Oestreich AE, Crawford AH. Atlas of pediatric orthopedic radiology. Stuttgart: Thieme, 1985:1, 17–18.

  7. Brill PW, Baker DH, Ewing ML. "Bone-within-bone" in the neonatal spine. Radiology 1973; 108:363–366.

    CAS  PubMed  Google Scholar 

  8. Hancox NM, Hay JD, Holden WS, Moss PD, Whitehead AS. The radiological "double contour" effect in the long bones of newly born infants. Arch Dis Child 1951; 26:543–548.

    Google Scholar 

  9. Edwards DK, III. Skeletal growth lines seen on radiographs of newborn infants. AJR Am J Roentgenol 1993; 161:141–145.

    PubMed  Google Scholar 

  10. Teele RL, Abbott GD, Mogridge N, Teele DW. Femoral growth lines: bony birthmarks in infants. AJR Am J Roentgenol 1999; 173:719–722.

    CAS  PubMed  Google Scholar 

  11. Lee JK, Yao L. Stress fractures: MR imaging. Radiology 1988; 169:217–220.

    PubMed  Google Scholar 

  12. Oestreich AE. Epiphyseal dysplasias and dysostoses. In: Taveras JM, Ferrucci JT, eds. Radiology: diagnosis, imaging, intervention, vol 5. Philadelphia: Lippincott, Williams & Wilkins, 2001:1–11.

  13. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford, CA: Stanford University Press, 1959.

  14. Mora S, Boechat MI, Pietka E, Huang HK, Gilsanz V. Skeletal age determinations in children of European and African descent: applicability of the Greulich and Pyle standards. Pediatr Res 2001; 50:624–628.

    CAS  PubMed  Google Scholar 

  15. Vanhoenacker FM, Van Hul W, Wuyts W, Willems PJ, De Schepper AM. Hereditary multiple exostoses: from genetics to clinical syndrome and complications. Eur J Radiol 2001; 40:208–217.

    Article  CAS  PubMed  Google Scholar 

  16. D'Ambrosia R, Ferguson Jr, AB. The formation of osteochondroma by epiphyseal cartilage transplantation. Clin Orthop 1968; 61:103–115.

    CAS  PubMed  Google Scholar 

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Acknowledgements

I thank Dr. Tal Laor of Cincinnati for her critical reading of this manuscript and her helpful suggestions. I also thank Professor Gurnot Jundt of Basel for his advice; Dr. Paula Brill of New York City for her assistance with references; and Glenn Miñano for image preparation.

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  1. Department of Radiology #H-5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3039, USA

    Alan E. Oestreich

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Correspondence to Alan E. Oestreich.

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Oestreich, A.E. The acrophysis: a unifying concept for enchondral bone growth and its disorders. I. Normal growth. Skeletal Radiol 32, 121–127 (2003). https://doi.org/10.1007/s00256-002-0604-y

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