Symptomatic Triradiate Cartilage Injury in a Female Adolescent: A Case Report
Tobias A Brucksch-Domanski, David Humphries
Keywords :
Adolescent, Case report, Magnetic resonance imaging, Overuse injury, Triradiate cartilage
Citation Information :
Brucksch-Domanski TA, Humphries D. Symptomatic Triradiate Cartilage Injury in a Female Adolescent: A Case Report. J Postgrad Med Edu Res 2024; 58 (2):83-85.
Introduction: The growing adolescent athlete has a significant risk for overuse injury due to multiple intrinsic and extrinsic factors. We present the case of an 11-year-old girl gymnast and multisport athlete with symptomatic stress injury to the right triradiate cartilage.
Case description: The injury was recognized on magnetic resonance imaging (MRI) following 6 months of right hip pain with activity. Load reduction strategies did not alter her symptoms, and rest from provocative activity was prescribed. A good outcome was achieved after 6 weeks with resolution of bone marrow edema and pain-free activity progression.
Conclusion: We place importance on the recognition of such overuse injuries to avoid long-term sequelae of growth plate injuries.
McKay D, Broderick C, Steinbeck K. The adolescent athlete: a developmental approach to injury risk. Pediatr Exerc Sci 2016;28(4):488–500. DOI: 10.1123/pes.2016-0021
Ponseti IV. Growth and development of the acetabulum in the normal child. Anatomical, histological, and roentgenographic studies. J Bone Joint Surg Am 1978;60(5):575–585.
Heeg M, Visser JD, Oostvogel HJ. Injuries of the acetabular triradiate cartilage and sacroiliac joint. J Bone Joint Surg Br 1988;70(1):34–37. DOI: 10.1302/0301-620X.70B1.3339056
Peagler CL Jr, Dobek AJ, Tabaie S. Trends in the use of total hip arthroplasty in the pediatric population: a review of the literature. Cureus 2023;15(8):e43978. DOI: 10.7759/cureus.43978
Ryan PM, Puttler EG, Stotler WM, et al. Role of the triradiate cartilage in predicting curve progression in adolescent idiopathic scoliosis. J Pediatr Orthop 2007;27(6):671–676. DOI: 10.1097/BPO.0b013e3181373ba8
Rodrigues KF. Injury of the acetabular epiphysis. Injury 1973;4(3):258–260. DOI: 10.1016/0020-1383(73)90048-x
Laor T, Wall EJ, Vu LP. Physeal widening in the knee due to stress injury in child athletes. AJR Am J Roentgenol 2006;186(5):1260–1264. DOI: 10.2214/AJR.04.1606
Bayer J, Neubauer J, Saueressig U, et al. Age- and gender-related characteristics of the pubic symphysis and triradiate cartilage in pediatric computed tomography. Pediatr Radiol 2016;46(12):1705–1712. DOI: 10.1007/s00247-016-3671-2
Liporace FA, Ong B, Mohaideen A, et al. Development and injury of the triradiate cartilage with its effects on acetabular development: review of the literature. J Trauma 2003;54(6):1245–1249. DOI: 10.1097/01.TA.0000029212.19179.4A
Ergen FB, Yildiz AE, Ayvaz M, et al. Bilateral triradiate cartilage injury: an overuse syndrome in an adolescent football player. Skeletal Radiol 2012;41(3):353–355. DOI: 10.1007/s00256-011-1335-8
McDonnell M, Schachter AK, Phillips DP, et al. Acetabular fracture through the triradiate cartilage after low-energy trauma. J Orthop Trauma 2007;21(7):495–498. DOI: 10.1097/BOT.0b013e31812f67ff
Dong Y, Wang J, Qin J, et al. Retrospective analysis of traumatic triradiate cartilage injury in children. BMC Musculoskelet Disord 2021;22(1):674. DOI: 10.1186/s12891-021-04565-2
Bucholz RW, Ezaki M, Ogden JA. Injury to the acetabular triradiate physeal cartilage. J Bone Joint Surg Am 1982;64(4):600–609.
Zbojniewicz AM, Laor T. Focal Periphyseal Edema (FOPE) zone on MRI of the adolescent knee: a potentially painful manifestation of physiologic physeal fusion? AJR Am J Roentgenol 2011;197(4):998–1004. DOI: 10.2214/AJR.10.6243