The trochlear pre-ossification center: a normal developmental stage and potential pitfall on MR images

Pediatr Radiol. 2012 Nov;42(11):1364-71. doi: 10.1007/s00247-012-2454-7. Epub 2012 Jul 19.

Abstract

Background: The hypertrophic changes that occur in the cartilage of an epiphysis prior to the onset of ossification are known as the pre-ossification center. Awareness of the appearance of the pre-ossification center on MR images is important to avoid confusing normal developmental changes with pathology.

Objective: The purpose of this study was to determine the characteristics of the trochlear pre-ossification center on MR imaging and examine age and gender differences.

Materials and methods: We retrospectively analyzed MR images from 61 children. The trochleas were categorized into three types on the basis of signal intensity (SI). Trochlear types were compared to age and gender.

Results: There was no significant difference between the ages of boys and girls. Type 1 trochleas showed homogeneous SI on all pulse sequences. Type 2 trochleas demonstrated a focus of high SI in the epiphyseal cartilage on fat-suppressed water-sensitive sequences, with high or intermediate SI on gradient-echo images (pre-ossification center). Type 3 trochleas showed low SI on fat-suppressed water-sensitive sequences and gradient-echo images. Thirty-seven trochleas were described as type 1, sixteen as type 2 and eight as type 3. ANOVAs confirmed a statistically significant difference in the age of children with type 3 trochleas and those with types 1 and 2 (P < 0.001). Spearman rank correlations determined a positive relationship between trochlear type and age of the children (r = 0.53).

Conclusion: Development-related changes in the trochlea follow a predictable pattern. The signal characteristics of the pre-ossification center likely reflect normal chondrocyte hypertrophy and an increase in free water in the matrix.

MeSH terms

  • Aging / pathology*
  • Aging / physiology*
  • Artifacts*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Humerus / anatomy & histology*
  • Humerus / growth & development*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Reproducibility of Results
  • Sensitivity and Specificity