Unusual Presentations of Focal Periphyseal Edema Zones: A Report of Bilateral Symmetric Presentation and Partial Physeal Closure
Table 2
Differential diagnosis MRI characteristics.
Pathology
MRI, T1
MRI, T2
MRI enhancement
FOPE zone
Relatively symmetric focal decreases signal intensity on both sides of central portion of narrowed or partially closed physis.
Relatively symmetric focal increased signal intensity on both sides of central portion of narrowed or partially closed physis.
Avid, uniform enhancement of areas of bone marrow edema.
Infiltrative bone tumor
Low signal typically on one side of the physis. Low signal distribution will be asymmetric if tumor does cross physis.
High signal typically on one side of the physis. High signal distribution will be asymmetric if tumor does cross physis.
Typically avid enhancement of areas of increased T2 signal. Enhancement is often heterogeneous.
Osteomyelitis
Low signal that may cross the physis. Distribution of low signal across physis is typically asymmetric. Other findings of infection such as cortical disruption, fluid collections, and periosteal reaction are often present.
High signal that may cross the physis. Distribution of high signal across physis is typically asymmetric. Other findings of infection such as cortical disruption, fluid collections, and periosteal reaction are often present.
Typically avid, heterogenous enhancement. Nonenhancing fluid collections may be present.
Chronic physeal stress injury
Widening of the physis typically without periphyseal low signal.
Widening of the physis typically without periphyseal high signal.
