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Journal of Bone and Joint Surgery, 1958;40:647-714.
© 1958 by The Journal of Bone and Joint Surgery, Inc

Ossification of the Distal Femoral Epiphysis

JOHN CAFFEY M.D.1, SAMUEL H. MADELL M.D.1, CHARLES ROYER M.D.1, and PABLO MORALES M.D.1

1 Department of Radiology, College of Physicians and Surgeons, Columbia University, and Babies Hospital, Presbyterian Hospital, New York

1. Irregularities of the margin of the ossification center in the distal femoral epiphyses are extremely common in normal children.

2. Often the irregularities take a form roentgenographically indistinguishable from osteochondritis dissecans. Our data do not deny the existence of osteochondritis dissecans in the femora of children, but they do indicate that it is much less frequent than the marginal irregularities described.

3. The patients in this series were asymptomatic and, even in several omitted from the study because of mild symptoms, the changes disappeared without treatment.

4. The evidence strongly suggests that the roentgenographic appearance of osteochondritis dissecans can be simulated by a normal variant of ossification in children.

5. Since many of the irregularities are located on the posterior aspect of the femoral condyles, the irregularity will often be seen in the tunnel view, while the anteroposterior roentgenogram does not show it as clearly.


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