Radiologic Prevalence and Features of Metacarpal Pseudoepiphysis on Normal Korean Children

Ho Min Lee; Jong Pil Kim; Suk Kang; Young Sung Kim; Min Young Lee

doi:10.4055/jkoa.2018.53.3.234

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Lee, Kim, Kang, Kim, and Lee: Radiologic Prevalence and Features of Metacarpal Pseudoepiphysis on Normal Korean Children

Original Article

Journal of the Korean Orthopaedic Association 2018; 53(3): 234-242.

Published online: 27 June 2018

DOI: https://doi.org/10.4055/jkoa.2018.53.3.234

Radiologic Prevalence and Features of Metacarpal Pseudoepiphysis on Normal Korean Children

Ho Min Lee, M.D., Jong Pil Kim, M.D.

, Suk Kang, M.D., Young Sung Kim, M.D., Min Young Lee, M.D.

Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.

Correspondence to: Jong Pil Kim, M.D. Department of Orthopedic Surgery, Dongguk University Gyeongju Hospital, 87 Dongdae-ro, Gyeongju 38067, Korea. TEL: +82-54-770-8221, FAX: +82-54-770-8378, kjpil@dongguk.ac.kr

Received 31 August 2017 Revised 28 September 2017 Accepted 11 October 2017

The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Pseudoepiphysis originates from the secondary ossification center of the non-ossification end during the normal pediatric growth process. It is not uncommonly found in the course of metacarpal and metatarsal ossification. We investigated the radiologic prevalence and features of pseudoepiphysis in normal Korean children.

Materials and Methods

Sex and age distribution following radiologic prevalence as well as the features of metacarpal pseudoepiphysis of 2,320 Korean children aged below 15 years of age and younger who underwent hand radiography between January 2009 and February 2016 were analyzed.

Results

A total of 304 out of 2,320 patients had pseudoepiphysis on metacarpal bone, which is a prevalence of 13.1%. Male showed higher prevalence (16.6% for male and 10.5% for female). The peak age was 11 years for boys and 5 years for girls. The first metacarpal bone was most prevalent, with 9.6% of the total population, followed by the second metacarpal bone (5.2%) and fifth metacarpal bone (2.5%). The prevalence of single pseudoepiphysis was 9.4%, and that of multiple pseudoepiphysis was 3.7%. The prevalence of incomplete pseudoepiphysis was 8.9% and was higher than complete pseudoepiphysis (5.6%).

Conclusion

The prevalence of metacarpal pseudoepiphysis in normal Korean children was 13.1%. It is necessary to be aware of the radiologic features and distributions of pseudoepiphysis to avoid misinterpretation as a bone disease or traumatic fracture in pediatric patients.

Keywords: pseudoepiphysis, metacarpal bone, secondary ossification, hand anomaly, Korean pediatrics

Figures and Tables

Figure 1

(A) Anteroposterior plain radiography of an 8-year-old female showing complete pseudoepiphysis (arrow) at the base of the second metacarpal bone. Radiolucent pseudoepiphyseal line crosses both the radial and ulnar sides of metacarpal cortex transversely. (B) Incomplete pseudoepiphysis (arrow) presenting at the second metacarpal base on a 6-year-old male radiography, as partial cortical discontinuity.

Figure 2

(A) Plain radiography of a 4-year-old male shows single pseudoepiphysis (arrow), as complete pseudoepiphysis of first metacarpal bone. (B) Radiography of an 11-year-old female showing multiple pseudoepiphysis (arrows) at three sites, each on the first, second, and fifth metacarpal bones. In the case, every pseudoepiphysis manifested as an incomplete pseudoepiphysis.

Figure 3

Male patients show higher prevalence of pseudoepiphysis, except for those aged younger than 1 years. An 11-year-old male and a 5-year-old female show the highest prevalence in each sex group. Dotted line shows a value of total pseudoepiphyseal prevalence of each sex.

Figure 4

Circular graph shows the proportion of complete and incomplete pseudoepiphysis by the site of expression. Total prevalence of each complete pseudoepiphysis was 5.0%, 4.0%, and 2.4% in the first, second, and fifth metacarpal bone, respectively, and each incomplete pseudoepiphyseal prevalence was 4.7%, 1.2%, and 0.1%.

Figure 5

Anteroposterior plain radiography of a 10-year-old female shows transverse radio-opaque line (arrows) on the distal end of the first metacarpal bone.

Table 1

Distribution of Metacarpal Pseudoepiphysis and Prevalence

^*Group which presents the highest prevalence in each population.

Table 2

Pseudoepiphysis by Sort of Metacarpal (MC) Bone Location

Values are presented as number (% prevalence). ^*Group which presents the highest prevalence in each population.

Table 3

Pseudoepiphysis by Sort of the Number of Expression

Values are presented as number (% prevalence). ^*Group which presents the highest prevalence in each population.

Table 4

Pseudoepiphysis by Sort of Amount of Cortical Involvement

Values are presented as number (% prevalence). ^*Group which presents the highest prevalence in each population.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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ORCID iDs: Jong Pil Kim
https://orcid.org/0000-0001-7433-2786
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