The paediatric metaphysis is afflicted by a wide range of pathological processes as it is the most metabolically active and well-vascularised part of the developing skeleton. This review focuses on metaphyseal marrow signal change detected with magnetic resonance imaging, which is most often occult on radiographs. When bilateral, these imaging appearances frequently present a diagnostic quandary. This review assists the radiologist to confidently dismiss physiological signal change and confidently work through the differential diagnosis. This is achieved by illustrating a practical method of classifying signal change into four categories: physiological red marrow, red marrow reconversion, marrow infiltration, and oedema-like marrow signal intensity. In doing so, various pathological entities are reviewed along with imaging pearls and next-step investigations.

Graphical abstract

中文翻译：

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图片回顾：磁共振成像区分双侧干骺端骨髓异常的挑战

儿科干骺端受到多种病理过程的影响，因为它是发育中骨骼中代谢最活跃且血管最丰富的部分。本综述重点关注磁共振成像检测到的干骺端骨髓信号变化，这种变化在射线照片上通常是隐匿的。当是双侧时，这些影像学表现经常会造成诊断困境。该审查可帮助放射科医生自信地消除生理信号变化并自信地进行鉴别诊断。这是通过说明将信号变化分为四类的实用方法来实现的：生理红骨髓、红骨髓再转化、骨髓浸润和水肿样骨髓信号强度。在此过程中，将审查各种病理实体以及成像珍珠和下一步研究。

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