Table 1

Scoring items and grades for physeal characteristics in the distal radius and ulna

Scoring item

Grades

Epiphysis

Bone marrow oedema

 Extent*

No oedema

<50% of epiphyseal volume

>50% of epiphyseal volume

 Location10 32

No oedema

Oedema adjacent to physis

Oedema not adjacent to physis

 Signal intensity*

No oedema

1

2

3

4

5

 Visibility on 3D WATSc*

No oedema

Oedema not visible

Oedema visible

Physis

Thickness9 20

Normal

Increased

 Location of thickness20

No increased thickness

Increased on radial side

Increased on ulnar side

 Thickness compared with proximal physis of MC-1*

Not increased

Twice

Three times

Four times

Signal intensity8

1

2

3

4

5

Disruptions32 33

No disruptions

1

2

>2 disruptions

 Width of disruptions*

No disruptions

<2 mm

≥2 mm

Physeal border on epiphyseal side25

Undulating

Irregular

 Depth of irregularities*

No irregularities

<Thickness of physis

>Thickness of physis

Metaphysis

Physeal border on metaphyseal side25

Undulating

Slightly irregular

Distinctly irregular

 Metaphyseal intrusions32 34

Absent

Present

 Signal intensity intrusions*

No intrusions

Less than physis

Same as physis

Higher than physis

 Connection of intrusion with physis*

No intrusions

Connected with physis

Not connected with physis

 Depth of intrusions*

No intrusions

<2 mm

>2 mm

Bone marrow oedema

 Presence10 32

Present

Absent

 Depth*

No oedema

Area <2 cm from physis

Area ≥2 cm from physis

 Location10 32

No oedema

Oedema adjacent to physis

Oedema not adjacent to physis

 Signal intensity*

No oedema

1

2

3

4

5

 Visibility on 3D WATSc*

No oedema

Oedema not visible

Oedema visible

 Homogeneity*

No oedema

Homogeneous oedema

Inhomogeneous oedema

Shape25

Normal

Unilateral widening

Bilateral widening

Location of widening*

No widening

Radial

Ulnar

Periosteal bone formation10

Absent

Present

Sclerosis2 9

Absent

Present

  • *Item added based on clinical experience with evaluation of physeal stress injuries.

  • 3D WATSc, three-dimensional water-selective cartilage scan; MC-1, first metacarpal bone.