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Topic: Metaphysis

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Epiphysis

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	PLATE 1
		The radiant area between the osseous femoral epiphysis and the metaphysis of the feniur is thinnest in the center.
		The radiant region between the osseous tibial epiphysis and the metaphysis of the tibia is the thinnest in the center.
		The metaphysis of the femur is primarily convex except for the small notch in the center.
	www.sgr-ssr.ch /Knieatlas/html/plate_1.html (481 words)

	Radiology Quiz
		The key to the diagnosis is an abnormal round piece of bone that projects between the proximal end of the ulna and the medial aspect of the distal humeral metaphysis on the frontal view (Figure E).
		The medial epicondyle is the protuberance from the posteromedial aspect of the distal humeral metaphysis, from which the flexor and pronator muscles and medial collateral ligaments arise.
		The medial epicondyle ossification center is usually seen by ages 4-6, and it is the last to fuse with the metaphysis, generally by age 15, earlier in females than males.
	www.childsdoc.org /winter2003/xrayquiz.asp (855 words)

	SALTER HARRIS PEDIATRIC ONCALL (Site not responding. Last check: 2007-11-06)
		The SH-V fracture is a crush injury of the physis.
		The radial epiphysis is slightly displaced dorsally with respect to the metaphysis.
		An SH-V fracture is a crush injury of the physis.
	www.pediatriconcall.com /fordoctor/DiseasesandCondition/Salter.asp (695 words)

	Metaphysis - Wikipedia, the free encyclopedia
		The metaphysis is the body of cartilage that separates the epiphyses and the diaphysis of long bones during growth.
		It is this part of the bone that grows during childhood; as it grows, it ossifies near the diaphysis and the epiphyses.
		Epiphyseal plates are located in the metaphysis and are responsible for growth in the length of the bone.
	en.wikipedia.org /wiki/Metaphysis (175 words)

	eMedicine - Salter-Harris Fractures : Article Excerpt by: William Moore, MD (Site not responding. Last check: 2007-11-06)
		Cartilage cells grow from the epiphysis towards the metaphysis, forming columns of cells that degenerate, fragment, and undergo hypertrophy.
		Neovascularization occurs from the metaphysis towards the epiphysis.
		A type II fracture is a fracture through the physis and metaphysis, but the epiphysis is not involved in the injury.
	www.emedicine.com /radio/byname/salter-harris-fractures.htm (644 words)

	esop ha hip prosthesis femoral stem femoral head
		The purpose of the study was to study the behaviour of both fastened parts in terms of warping and constraints, mainly at the shaft / metaphysis unit.
		Various components were studied: aluminium oxide beads, metaphysis parts, shaft parts, cortical bones, upper spongy bone and lower spongy bone.
		The maximum figures (15.4 daN/mm2) were found on the metaphysis part, in the area connecting the stem holding the bead and the massive section.
	www.esop-hip.com /us/gamme.htm (402 words)

	[No title] (Site not responding. Last check: 2007-11-06)
		The metaphysis is richly supplied with blood both from terminal branches of the nutrient artery as well as from the metaphyseal arteries arising from the ascending cervical arteries.
		While the metaphysis and the fibrous peripheral components of the growth plate have an abundant blood supply, only the proliferative zone of the cartilage portion of the growth plate is adequately supplied with blood.
		The functions of the metaphysis therefore, are vascular invasion of the transverse septa at the bottom of the cartilaginous portion of the growth plate, bone formation, and remodeling, both internal and histologic (removal of calcified cartilage bars and replacement of fiber bone with lamellar bone) and external or anatomic (funnelization of the metaphysis).
	cal.vet.upenn.edu /saortho/chapter_02/02mast.htm (7023 words)

	Joint Pain in Children, Part VI: Bone Infections in Children \| Deborah Pate, DC, DACBR
		The infection typically originates in the metaphysis of the long bones, a highly vascular area.
		The infection may then spread rapidly by way of vascular channels through the medullary cavity and the bone cortex, which is thin in the region of the metaphysis and provides easy access to the periosteum.
		An initial break in the bony trabeculae of the metaphysis will appear and will progress to become larger areas of lytic destruction which appear as radiolucent areas in the metaphyseal region.
	www.chiroweb.com /archives/15/25/06.html (1317 words)

	[No title]
		The radial head fracture is best seen on the AP view on the lateral size (left on the screen) of the radial metaphysis as a slight irregularity in the cortex.
		The slope from the diaphysis to the metaphysis towards the radial head should be gradual and smooth with no sharp angles associated with it.
		The smooth contour of the radial head as one proceeds from the epiphysis to the metaphysis should be carefully inspected.
	www.mdchoice.com /pediatric/v1/case17a.asp (528 words)

	Orthopaedic - The ESOP femoral component concept
		All the stresses were intended to be transferred via the proximal metaphysis, so as not to stress the junction, and so as to transmit the stresses into the proximal femur without putting load directly onto the shaft.
		Stability was intended to come from the "crouching" of the implant in the metaphysis; therefore, the metaphyseal part had to be wider laterally and in the a.p.
		After the resection of the neck, a special chisel is used to enter the metaphysis as far laterally as possible and in the femoral axis, leaving a little cancellous bone on the medial side.
	www.maitrise-orthop.com /corpusmaitri/orthopaedic/mo67_ray_esop/ray_esop.shtml (3347 words)

	Movement Specialist -- Salter-Harris Fracture Classification
		In the second through fourth types, the metaphysis (M) and/or epiphysis (E) is fractured.
		Then note that a fracture is not visible in either the epiphysis or the metaphysis.
		The fracture line passes through the metaphysis into the epiphyseal plate, but no fracture is observed into the epiphysis.
	members.aol.com /ptdoctor/salter-harris.html (860 words)

	Skeletal Infections
		In children through the age of puberty the long bones of the extremities are most often involved with the metaphysis as the initial infected site.
		In children, the metaphysis is very active metabolic tissue with a large blood flow and with vasculature predisposed to infection.
		The host responds to the presence of bacteria in the metaphysis with a local increase in vascular permeability, resulting in edema, increased vascularity and the influx of polymorphonuclear leukocytes.
	www.kcom.edu /faculty/chamberlain/Website/tritzid/skelinfe.htm (1376 words)

	Premature Partial Closure and Other Deformities of the Growth Plate: MR Imaging and Three-dimensional Modeling -- Craig ...
		metaphysis, especially in the posteromedial aspect (Fig 8).
		Anteriorly, the tibial growth plate is unremarkable, but posteriorly there is marked thickening and irregularity (arrows) with one deep intrusion into the metaphysis (arrowhead).
		cartilage in the metaphysis (Fig 6b, 6c), or widening and irregularity
	radiology.rsnajnls.org /cgi/content/full/210/3/835 (5840 words)

	MuscSktf7-Osteomyelitis_Text_pv
		The lesion is seen to involve the metaphysis and diaphysis of the distal left tibia.
		This situation provides a vascular connection between the metaphysis and the epiphysis and explains the frequency of epiphyseal infections in neonates.
		In the adult, with closure of the growth plate, vascular continuity between the epiphysis and metaphysis is restored.
	www.mribhatia.com /muscktf7/muscsktf7_text_pv.html (2889 words)

	Giant Cell Tumor - Tutorial
		Because this tumor lies in the metaphysis and commonly borders the articular cartilage, patients may present with symptoms of a primary joint problem simulating a condition such as a meniscal tear, torn ligament, arthritis or post-traumatic contusion.
		Giant cell tumors begin in the metaphysis and then grow in a centripetal fashion towards the articular cartilage (Slide 7).
		In a small percentage of patients, the lesion is confined to the metaphysis and does not enter the epiphysis.
	dev.slackinc.com /aaosdemo/Tutorials/tumors/gct/tutorial.cfm (1571 words)

	Salter-Harris Classification
		With type II fractures, there is a division between epiphysis and metaphysis except for a flake of metaphyseal bone carried with epiphysis (Thurston Holland sign).
		The growth mechanism is a complex structure, consisting of the physis, epiphysis, and metaphysis (5).
		The healing process in the animals that were treated with anatomical reduction and rigid internal fixation occurred without the formation of osseous callus, and no marked abnormalities were discernible in the physis.
	www.bridgeport.edu /~gwl/salter-harrisclassification.htm (1293 words)

	Radiology In Ped Emerg Med, Vol 4, Case 2
		Metaphyseal Fractures Metaphyseal fractures were first described by Caffey in 1972, who felt they represented an indirect avulsion injury to the metaphysis by the pull of the periosteum when the child was severely shaken.
		In 1983, Kleinman and Zito showed these to be transverse fractures through the metaphysis and only appeared to be avulsion injuries because of the radiographic projection views.
		If the metaphysis is tipped or simply projected obliquely to the X-ray beam, the margin of the resultant fragment is projected with a bucket-handle appearance.
	www.hawaii.edu /medicine/pediatrics/pemxray/v4c02.html (1477 words)

	Radiology In Ped Emerg Med, Vol 1, Case 18
		No fractures of the epiphysis or the metaphysis are visible.
		The radius fracture extends from the metaphysis into the physis.
		This radiograph shows a fracture of the medial malleolus extending from the inferior articular surface of the tibial epiphysis through the physis and extending through the metaphysis.
	www.hawaii.edu /medicine/pediatrics/pemxray/v1c18.html (666 words)

	Growth Plate Injuries
		When growth is disturbed, the reason is one of the following: avascular necrosis of the plate, crushing or infection of the plate; formation of a callous bridge between the epiphysis and metaphysis; nonunion; and hyperemia producing local overgrowth.
		Type I: The Type I fracture completely separates the epiphysis from the metaphysis; the germinal cells remain with the epiphysis.
		The fracture passes from the joint surface, across the epiphyseal growth plate and into the metaphysis.
	www.chiroweb.com /hg/13/17/11.html (697 words)

	Article : A Case Of Congenital Syphilis ; Author : MK Saraswat ; Co-Author(s) : A Gupta, S Tejwani, M Singhal ; Vol / ... (Site not responding. Last check: 2007-11-06)
		The usual manifestations of congenital syphilis appear during the first two years of life presenting with jaundice, hepatosplenomegaly, lymphadenopathy, erythematous maculo-papular or bullous lesions, mucosal patches, rhinitis (Snuffles), condylomatous lesions, but bone and joint manifestations are most common occurring in about 85% of cases.
		Involvement is classically bilaterally symmetrical and widespread, metaphysis of long bones being particularly affected especially around the knee joint.
		Periosteitis which is most common may be seen as a thin layer or more marked laminated layers, less commonly diaphysitis manifests as scattered foci of cortical destruction and dilation of the medullary cavity, epiphyseal plate too may show a focal destructive lesion.
	www.ijri.org /articles/archives/2002-12-4/letter_579.htm (420 words)

	Hypertrophic Osteodystrophy
		There are severe inflammatory changes going on in the metaphysis and resultant changes in the local blood flow.
		The usual microscopic changes, which are seen in the metaphysis are inflammation, hemorrhage, necrosis (cellular death), microfractures and remodeling of the bone.
		The periosteal new bone formation may form a collar around the bone, localized to the inflamed metaphysis, or it can be rather extensive and extend several centimeters toward the mid bone.
	www.angelfire.com /az2/iscaz/hypertrophic__osteodystrophy.htm (1126 words)

	How To Detect Pediatric Osteomyelitis
		Acute hematogenous osteomyelitis in children is an uncommon but not rare systemic disease that occurs primarily in the metaphysis of long bones.
		Morbidity mostly occurs via delays in diagnosis that may be due to negative culture results and/or a poor understanding of the pathophysiology of bone infections that can lead to mismanagement of the patient.
		Although AHO is more common in the metaphysis, Kramer reported a case of an 11-year-old child with epiphyseal involvement.
	www.podiatrytoday.com /article/4305 (2830 words)

	Analysis of 51 Tibial Triplane Fractures Using CT with Multiplanar Reconstruction -- Brown et al. 183 (5): 1489 -- ...
		In classic lateral two-fragment fracture, posterolateral fragment, consisting of posterolateral epiphysis and posterior metaphysis, separates from anteromedial epiphysis, which remains attached to tibial shaft.
		In classic medial three-fragment fracture, separation of physis at Kump's bump results in one free anterolateral epiphyseal fragment, one fragment that involves rest of epiphysis and posterior metaphysis, and one main fragment corresponding to remaining tibial metaphysis and shaft.
		the posterior metaphysis (two-fragment) or isolated from the
	www.ajronline.org /cgi/content/full/183/5/1489 (3568 words)

	OCD
		Toward each end of the bone, a slightly flattened area is called the metaphysis (to grow beyond), and the small knob-like structures at each end (4 in all) are called the epiphysis (to grow upon).
		Both the metaphysis and the epiphysis are made of bony material that looks like a sponge with air pockets, and yet it is still very strong.
		Separating the metaphysis and the epiphysis in a young growing dog are the growth plates, or epiphyseal plates, made of cartilage and bone-forming cells.
	www.jersey.net /~mountaindog/berner1/ocd.htm (1256 words)

	Anatomic Location
		Type I: Epiphyseal separation from the metaphysis through the entire length of physis.
		The fracture involves both the physis and the metaphysis.
		The fracture courses through the epiphysis, physis and the metaphysis (again an articular fracture).
	sacs.vetmed.ufl.edu /notes/CROSS/newpage6.htm (211 words)

	Age-Related Vascular Changes in the Epiphysis, Physis, and Metaphysis: Normal Findings on Gadolinium-Enhanced MRI of ...
		In both proximal and distal femoral epiphyses, marked enhancement is observed in physis (white arrow) and in band (fl arrow) in juxtaphyseal metaphysis corresponding anatomically to metaphyseal spongiosa.
		On unenhanced sagittal image of distal femur, cartilage is of homogenous intermediate signal intensity, and marrow is of low signal intensity in metaphysis and secondary ossification center (O).
		In metaphysis, difference in enhancement between younger and older animals is less marked, which probably reflects greater marrow change of epiphysis compared with marrow change in metaphysis.
	www.ajronline.org /cgi/content/full/182/2/353 (4221 words)

	WHAT IS YOUR DIAGNOSIS (56/2)
		Premature closure of the growth plate of the Radius (arrow A) Retained epiphyseal joint cartilage of the ulna at the carpal joint space (arrow B) Hypertrophic growth of the distal metaphysis of the ulna (arrow C) Diagnosis:
		A long "tongue" of hypertrophied cartilage extends into the metaphysis.
		Ischemia of the metaphysis has been suggested as a cause for the lack of calcification of the cartilage.
	www.isrvma.org /article/56_2_da.htm (197 words)

	PLATE 3
		In the femur the span of reciprocal shaping between the inner bone margin of the epiphysis and the surface of the metaphysis is almost equal to the transverse diameter of the epiphysis.
		The tibial metaphysis is flattened centrally, but reciprocal shaping between epiphysis and metaphysis has not advanced as far as in the femur.
		The entire outer bone margin of each epiphysis is rounded; the inner bone margin is flattened, particularly the inner bone margin of the tibial epiphysis.
	www.sgr-ssr.ch /Knieatlas/html/plate_3.html (408 words)

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