The patterns of musculoskeletal injury in infants, children, and adolescents differ considerably from those that occur in adults. The immature skeleton is structurally and mechanically different and responds differently to stress. The types of injury in the lower extremity are similar to those that occur in other portions of the immature skeleton, but unique types of injury exist in certain locations. A thorough understanding of the pathophysiology and imaging characteristics of the common and sometimes subtle injuries that occur in pediatric patients is crucial for prompt diagnosis and appropriate management. Despite well-established trauma protocols and improved imaging techniques, delays in diagnosis of such injuries still occur (1). Most fractures are adequately evaluated with radiographs, but cartilaginous and ligamentous injuries may require advanced imaging, such as magnetic resonance (MR) imaging. Computed tomography (CT) is useful for surgical planning with complex injuries at the joints. Ultrasonography (US) has limited usefulness in the detection of fractures and ligamentous injuries. This chapter illustrates the unique features of injuries in pediatric patients and includes discussion of optimal imaging strategies.
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