In an 11‑year‑old male, would you expect to see an epiphyseal (growth) plate at the lateral distal femur?

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Growth Plate Visibility at the Lateral Distal Femur in an 11-Year-Old Male

Yes, you would absolutely expect to see a growth plate (physis) at the lateral aspect of the distal femur in an 11-year-old male, as this growth plate typically remains open until approximately 14-16 years of age in males.

Normal Skeletal Development

  • The distal femoral physis is one of the most active growth plates in the body and contributes significantly to lower extremity length, accounting for approximately 37% of femoral growth and 70% of growth about the knee 1.

  • In prepubertal and early pubertal children (which includes most 11-year-old males), the distal femoral growth plate appears as a radiolucent line on radiographs, separating the metaphysis from the epiphysis 1.

  • Growth plates demonstrate increased signal on MRI fluid-sensitive sequences and appear as areas of normal increased activity on bone scintigraphy due to active bone formation 1.

Age-Specific Considerations

  • The distal femoral physis typically closes between ages 14-16 years in males (slightly earlier in females at 12-14 years), making an 11-year-old male well within the expected age range for an open growth plate 1.

  • At 11 years of age, the child is typically in Tanner stage 2-3, during which all major long bone growth plates remain open and actively growing 1.

Clinical Imaging Implications

  • On plain radiographs, the growth plate appears as a transverse radiolucent line at the distal femur, which should not be mistaken for a fracture 1.

  • The physis is normally symmetric bilaterally, so comparison views of the contralateral limb can be helpful if there is concern about pathology versus normal anatomy 1.

  • Growth plate injuries (Salter-Harris fractures) are common in this age group because the physis represents a relative point of weakness compared to surrounding bone and ligaments 1.

Important Caveats

  • Premature physeal closure can occur following trauma, infection (particularly septic arthritis or osteomyelitis involving the growth plate), or avascular necrosis 1.

  • Certain systemic conditions may affect growth plate appearance, including metabolic bone diseases, though these would typically affect multiple growth plates rather than an isolated finding 1.

  • If a growth plate is NOT visible at this age when expected, this warrants investigation for premature closure, prior trauma, infection, or developmental abnormality 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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