British medical bulletin
October 5, 2026 · via Europe PMC
Knee physeal stress injury and osteochondrosis in pediatric athletes: a systematic review.
Forero-Millan J, Gebregiorgis BT, Işın A, Liu GL, Caine D, Nguyen JC
AI summary — for doctors, generated from the abstract only
Knee growth-plate stress injuries and osteochondroses in young athletes are poorly studied, usually begin with conservative care, and can be missed on early radiographs.
What was studied
PRISMA systematic review of PubMed, Scopus and Embase for knee physeal stress injuries and osteochondroses in skeletally immature athletes, yielding 16 articles covering 26 patients and 31 knees.
Key findings
- Evidence is very limited and mostly small case-level reports.
- Radiographs and MRI are the main imaging tools; early radiographic signs are often subtle and MRI may be needed.
- Treatment typically starts conservatively, with surgery for failure or significant growth disturbance or deformity.
- Optimal duration of conservative care and surgical indications remain uncertain.
Clinical relevance
Delayed diagnosis can lead to growth arrest and deformity, so a young athlete with persistent knee pain and normal films may warrant MRI.
Who should care
Limitations
Only 26 patients from small reports, so conclusions on treatment and outcomes are weak.
Keep a low threshold for MRI in skeletally immature athletes with persistent knee pain and initially normal radiographs.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
Epiphyseal physeal stress injuries (PSIs) and articular osteochondroses of the knee in pediatric athletes are incompletely understood. Delayed diagnosis can lead to growth arrest and osseous deformity, increasing the need for surgical correction and long-term morbidity.
SOURCES OF DATA
A systematic review was performed using PRISMA guidelines. PubMed, Scopus, and Embase databases were searched to identify peer-reviewed publications on the occurrence, diagnosis, and outcome of epiphyseal PSIs and articular osteochondroses of the knee in skeletally immature pediatric athletes, yielding 16 articles (26 patients: 17 males and 9 females; 31 knees). Study quality, demographic data, sports activity, imaging findings, treatment, and outcomes were collected and summarized using descriptive statistics.
AREAS OF AGREEMENT
There is a relative paucity of data on epiphyseal PSIs and articular osteochondroses affecting the knee. Radiographs and MRI are commonly used for evaluation. Treatment typically begins with conservative management; surgical intervention is considered when conservative treatment fails or substantial growth disturbance or skeletal deformity is present.
AREAS OF CONTROVERSY
The optimal duration of conservative treatment and the indications, timing, and type of surgical intervention remain uncertain because the available evidence is limited.
GROWING POINTS
Early radiographic findings of epiphyseal PSIs or articular osteochondroses of the knee are often subtle, and MRI may be needed to clarify the diagnosis and exclude alternative diagnoses.
AREAS TIMELY FOR DEVELOPING RESEARCH
Surveillance across youth sports should include epiphyseal PSIs and articular osteochondroses of the knee. Prospective longitudinal epidemiological and imaging studies are needed to better characterize incidence, prevalence, natural history, and complication rates.
DOI
10.1093/bmb/ldag036
PMID
42911874
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed