Toma Tania, Tekle Kifle, Smith Joely, Quest Rebecca, Kelly Rachel, Lord Christopher, Alavi Afshin
Imaging Department, Imperial College NHS Healthcare Trust, St Mary's Hospital, The Bays S Wharf Rd, London, W2 1NY, UK.
Department of Infectious Diseases, Imperial College London, St Mary's Hospital, The Bays S Wharf Rd, W2 1NY, London, UK.
Emerg Radiol. 2025 Aug 15. doi: 10.1007/s10140-025-02364-z.
Paediatric fractures are common in emergency settings, with accurate diagnosis crucial in preventing complications like malunion and early osteoarthritis. Computed Tomography (CT) is often the standard for fracture assessment but involves ionizing radiation, posing added risks for children. Zero Echo Time (ZTE) MRI produces CT-like bone imaging without radiation, offering a safer alternative for paediatric patients. We report the case of a 13-year-old boy presenting with lateral malleolar pain following an inversion injury. Although initial radiographs revealed a joint effusion, a convincing fracture was not identified. Subsequent ZTE MRI easily detected a fracture through the lateral tibial epiphysis and physis, consistent with a Salter-Harris III injury. This case highlights ZTE's capability in detecting radiographically occult fractures, making it a valuable tool for accurate paediatric fracture diagnosis without radiation exposure.
小儿骨折在急诊中很常见，准确诊断对于预防诸如畸形愈合和早期骨关节炎等并发症至关重要。计算机断层扫描（CT）通常是骨折评估的标准方法，但涉及电离辐射，给儿童带来额外风险。零回波时间（ZTE）磁共振成像（MRI）可产生类似CT的骨成像且无辐射，为儿科患者提供了更安全的选择。我们报告一例13岁男孩在发生内翻损伤后出现外踝疼痛的病例。尽管最初的X线片显示有关节积液，但未发现明显骨折。随后的ZTE MRI很容易检测到穿过胫骨外侧骨骺和骺板的骨折，符合Salter-Harris III型损伤。该病例突出了ZTE在检测X线隐匿性骨折方面的能力，使其成为在无辐射暴露情况下准确诊断小儿骨折的有价值工具。
