Scitigraphic patterns of growth plates: Age related normal variations

Objectives Scintigraphic appearance of the normal growth plate changes with age. Full investigation of age related scintigraphic patterns of growth plate’s has not been reported. The objective of the study is to evaluate age related pattern of distal femur & proximal tibia growth plates on bone scan

Methods A retrospective analysis of bone scans in pediatric age group was done. Anterior & posterior views of the whole-body scan were visually reviewed by two nuclear medicine physicians to establish characteristics of the growth plates in the distal femur and proximal tibia regarding the shape of the plate, segmental pattern of radiotracer uptake through the plate. Quantitative assessment was performed to complement visual assessment findings.

Results 89 patients were found during the study. Various patterns of growth plate’s uptake were recognized in different age groups. In infants and children below age of five, the plate appears ovally shaped with uniform uptake. Later it appears as linear with nonuniform uptake till the age of ten. Between age 10 and 15, a peculiar pattern of biconcave & nonuniform uptake is seen. After the age 15, the plates show progressive fading of activity with gender difference. Excellent agreement was obtained between visual & quantitative assessment regarding segmental uptake of the plate.

Conclusions Age related patterns of growth plate’s uptake on bone scan have been identified. Recognition of these appearances is important because lack of such knowledge may lead to misinterpretation of growth plate abnormalities.