Radiographic Study Of The Development Of Calcaneal Epiphysis

Objective: To investigate the X-ray features and regulations of calcaneal epiphysis from its appearance to closure.Materials and Methods: From May 2012 to Febrary 2016,1177 consecutive children and adolecents under 19 years old who underwent lateral X-ray examinations of single ankle,foot or tarsus in Rizhao People's Hospital were enrolled in the studay.There were673 males and 504 females.The age range was from 4 months to 18 years old.The patients in each age were set as one group,and there were 20-50 males or females in each group.The number of calcaneal epiphysis which was appeared and total closed,the density of the epiphysis(sclerosis type and cancellous bone type),bottom and upper part of the first closure place of calcaneal epiphysis,radiolucent lines and temporary calcaneus spur appeared or not in each group were observed and these features and regulations with age and gender were analyzed.Results:All the children and adolecents that observed,in females,one case with the earliest calcaneal epiphysis appearing was in 3-year-old group,and all showed calcaneal epiphysis appearing in 9-year-old group and older groups;one case with the earliest calcaneal epiphysis completely closing was in 11-year-old group,and all showed epiphysis completely closing in 16-year-old group and older groups.And in males,one case with the earliest calcaneal epiphysis appearing was in 5-year-old group,and all showed calcaneal epiphysis appearing in 11-year-old group and older groups;one case with the earliest calcaneal epiphysis completely closing was in 12-year-old group,and all showed epiphysis completely closing in 18-year-old group.Fifty-four children showed temporary calcaneus spur(fake spur)in the all cases before the appearance of epiphysis,nineteen cases were female and thirty-five cases were male.There was no significant difference between male and female regarding to density of epiphysis,bottom and upper part of the first closure place of calcaneal epiphysis,radiolucent lines and temporary calcaneus spur appeared or not(?2=1.22,0.03,0.52,2.45,all P>0.05).In the all cases,the first closure place of bottom accounts for 6.55%(male 12 cases,female 17 cases)and the upper accounts for 2.93%(male 5 cases,female 5 cases)Conclusion: Identifying the growth and development characteristics of the calcaneal epiphysis is helpful to make X-ray diagnosis and differential diagnosis for disorders of calcaneal epiphysis.