Perera Molligoda Arachchige AS, Schmiliver B, Patel HA. Imaging of pediatric musculoskeletal trauma: Age-specific considerations and challenges. World J Clin Pediatr 2026; 15(2): 113603 [DOI: 10.5409/wjcp.v15.i2.113603]
Corresponding Author of This Article
Arosh S Perera Molligoda Arachchige, MD, Faculty of Medicine, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele 20072, Lombardy, Italy. aroshperera@outlook.it
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Jun 9, 2026; 15(2): 113603 Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.113603
Imaging of pediatric musculoskeletal trauma: Age-specific considerations and challenges
Arosh S Perera Molligoda Arachchige, Bianca Schmiliver, Helly A Patel
Arosh S Perera Molligoda Arachchige, Bianca Schmiliver, Faculty of Medicine, Humanitas University, Pieve Emanuele 20072, Lombardy, Italy
Arosh S Perera Molligoda Arachchige, Independent Researcher, Milan 20144, Lombardy, Italy
Helly A Patel, Independent Researcher, Atlanta, GA 30309, United States
Co-first authors: Arosh S Perera Molligoda Arachchige and Bianca Schmiliver.
Author contributions: Arachchige ASPM wrote the manuscript with support from Schmiliver B and Patel HA; Schmiliver B helped supervise the project; Arachchige ASPM conceived the original idea and supervised the project; Arachchige ASPM and Schmiliver B have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Corresponding author: Arosh S Perera Molligoda Arachchige, MD, Faculty of Medicine, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele 20072, Lombardy, Italy. aroshperera@outlook.it
Received: August 29, 2025 Revised: September 17, 2025 Accepted: January 26, 2026 Published online: June 9, 2026 Processing time: 257 Days and 11.1 Hours
Abstract
Pediatric musculoskeletal trauma differs significantly from adult injuries due to the dynamic and evolving nature of the growing skeleton. The presence of open growth plates (physes), secondary ossification centers, and a more elastic bone structure contributes to unique injury patterns and imaging findings in children. Proper interpretation of pediatric imaging requires an in-depth understanding of age-specific anatomy, biomechanics, and normal developmental variants. This review provides a comprehensive overview of pediatric bone physiology and fracture types, including the Salter-Harris classification, special pediatric fractures, elbow ossification, avulsion injuries, and conditions related to repetitive stress. Additionally, we address the critical topic of non-accidental trauma, underscoring the radiologist’s role in early detection. Through an anatomical and pathophysiological lens, this paper explores the challenges and strategies for accurate diagnosis in pediatric trauma imaging.
Core Tip: Pediatric musculoskeletal trauma presents unique imaging challenges due to growth plates, ossification centers, and elastic bone structure. Accurate diagnosis requires knowledge of age-specific anatomy, developmental variants, and injury patterns. This review highlights fracture classifications, special injuries, and non-accidental trauma, emphasizing the radiologist’s critical role in early, precise evaluation.
