Maturation of pelvic ossification centers on computed tomography in normal children

Pediatr Radiol. 2018 Dec;48(13):1902-1914. doi: 10.1007/s00247-018-4233-6. Epub 2018 Sep 3.


Background: The pelvis is composed of three paired primary ossification centers: the pubis, the ischium and the ilium. During maturation, multiple secondary ossification centers can be seen in the synchondroses between these bones and in the pelvic apophyses. The fragmented appearance of these centers can be confused with pathology.

Objective: To examine development of pelvic ossification centers by CT and determine normal appearance throughout childhood.

Materials and methods: Three pediatric radiologists reviewed 325 pelvic CT scans in children and young adults 5-18 years old and graded 6 pelvic ossification centers to evaluate maturational changes in critical structures.

Results: Rate and progression of ossification and age at complete fusion vary with gender at the different ossification centers in the growing pelvis.

Conclusion: Knowledge of the normal CT appearance of ossification centers throughout childhood is important to differentiate the normal appearance from pathology.

Keywords: Children; Maturation; Ossification centers; Pelvis; Synchondroses; Triradiate cartilage.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Osteogenesis / physiology*
  • Pelvic Bones / diagnostic imaging*
  • Pelvic Bones / growth & development*
  • Reference Values
  • Tomography, X-Ray Computed*