Unusual Presentations of Focal Periphyseal Edema Zones: A Report of Bilateral Symmetric Presentation and Partial Physeal Closure

Figure 4

A 13-year-3-month-old female with FOPE zones at both proximal tibiae. Findings: (a) sagittal proton density fat-saturated image on the 6-month follow-up MRI of the right knee shows interval development of 9 mm in diameter area of periphyseal edema on both the epiphyseal and metaphyseal sides of the proximal tibia physis (arrow). The proximal tibia physis is narrowed but remains open. (b) Axial proton density fat-saturated image at the level of the proximal tibia physis shows the periphyseal edema located at the anterolateral aspect of the central physis (asterisk). Technique: (a) sagittal PD fat-saturated MRI (TR = 2,958.3, TE = 30), ST = 3 mm, spacing = 3.3 mm, FOV = 14 cm, and matrix = 364 × 261; (b) axial PD fat-saturated MRI (TR = 2,843.3, TE = 30), ST = 3 mm, spacing = 3.3 mm, FOV = 15 cm, and matrix = 376 × 297.

(a)

(b)