From the Guidelines
When interpreting a suspected growth plate on an MRI, you should primarily trust the pediatric radiologist's assessment, as they are best suited to minimize the risk of missed findings or misinterpretation of normal developmental anatomy as abnormal. While both specialists are highly trained, pediatric radiologists have the expertise to accurately interpret imaging studies, including MRIs, and are particularly skilled in distinguishing between normal and abnormal findings in pediatric patients 1. Pediatric orthopedic surgeons, on the other hand, specialize in the treatment and management of bone and joint issues, but may not have the same level of expertise in interpreting advanced imaging studies.
- Key considerations when interpreting a suspected growth plate on an MRI include:
- The importance of accurate interpretation to guide treatment and management decisions
- The potential for misinterpretation of normal developmental anatomy as abnormal
- The need for collaboration between pediatric radiologists and orthopedic surgeons to ensure comprehensive care
- Ideally, these specialists should work together, with the radiologist providing detailed imaging interpretation and the orthopedic surgeon integrating these findings with clinical examination, patient history, and treatment planning 1. If you encounter conflicting opinions, consider seeking a second opinion from another pediatric radiologist or requesting a consultation where both specialists can discuss their interpretations together to reach a consensus about your child's condition.
From the Research
Interpreting Suspected Growth Plate on an MRI
When it comes to interpreting a suspected growth plate on an MRI, both paediatrics orthopaedics surgeons and radiologists play crucial roles. The decision of whom to trust should be based on their expertise and the specific context of the case.
Expertise in MRI Interpretation
- Paediatrics orthopaedics surgeons have in-depth knowledge of growth plate injuries and their treatment, as evidenced by studies such as 2 and 3, which highlight the importance of MRI in evaluating growth plate injuries and predicting outcomes.
- Radiologists, on the other hand, specialize in interpreting imaging studies, including MRIs, and have a deep understanding of the appearance of growth plates on MRI, as discussed in studies like 4 and 5.
Studies on Growth Plate Injuries
- A study published in 1998 4 found that MRI changed the Salter-Harris classification or staging in 2 of 9 patients with fractures visualized on conventional radiographs and allowed the detection of radiographically occult fractures in 5 of 14 cases.
- Another study from 2020 6 demonstrated that quantitative MRI can help monitor the status of the growth plate and capture its changes early, which can be crucial in predicting and preventing growth disturbances.
Collaboration and Decision-Making
- In practice, both paediatrics orthopaedics surgeons and radiologists often work together to interpret MRI findings and make treatment decisions, as each brings their unique expertise to the table.
- The study from 2000 2 suggests that MRI provides useful information on the appearance of the growth plate and changes in the metaphysis, which can affect the prognosis and results of surgical procedures, highlighting the importance of collaboration between specialists.