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| Version | User | Scope of changes |
|---|---|---|
| Jun 20 2008, 9:16 AM EDT | M.J.Fuller | 13 words added, 4 words deleted, 1 photo added |
| Jun 19 2008, 6:16 AM EDT | M.J.Fuller |
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Introduction
The Normal Humeral Epiphysis
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Soft tissue signs can assist in differentiating normal bony anatomy from an acute bony injury. This page considers soft tissue signs associated with the shoulder.
The Normal Humeral Epiphysis
I have seen a normal paediatric proximal humeral epiphysis reported as a fracture on several occasions. In such cases, an examination of the adjacent soft tissues would suggest that no fracture was present.
The arrowed structures are actually a single structure (proximal humeral epiphysis). The reasons that the proximal humeral epiphysis appears to be two structures are as follows.
- The proximal humeral epiphysis is "V" shaped and one side of the "V" is seen en face(ish) and the other side of the "V" is visualised in profile (ish).
- The other deceptive aspect is that one side of the "V" appears to have a sclerotic margin (black arrow) and the other doesn't.doesn't(white arrow).
This image can help in understanding the nature and shape of the proximal humeral epiphysis. This patient has a Salter Harris I injury to the proximal humeral epiphysis. http://www.e-radiography.net/
Insert image here This patient does have a fracture of the proximal humerus. The distinction between the normal proximal humeral epiphyses and the fracture are clearly evident. Note the adjacent soft tissue swelling (white arrow).
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