Differential Diagnosis of Secondary Center of Ossification Abnormalities

The anatomy of a child’s bone may be divided into its basic components: the epiphysis, physis, metaphysis, and diaphysis. An appreciation of the growth and function of each structure is critical whenever a clinician encounters pathologies in the pediatric skeleton. The following review discusses the differential diagnoses of abnormal secondary centers of ossification (SCO), a topic which is infrequently considered in orthopaedic literature, but may result in significant morbidity and mortality in the pediatric patient. It provides the fundamental tools in approaching children with this condition in two ways: First, by surveying the basic anatomy and physiology of the pediatric skeleton. Second, by describing the basic types of irregular SCO one may encounter. The following discussion will assist clinicians in developing a practical approach towards the differential diagnoses of abnormal secondary centers of ossification. Anatomy and growth of the pediatric skeleton