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Focal Periphyseal Edema: An Uncommon Cause of Adolescent Knee Pain

A Report of Three Cases

Speirs, Joshua N. MD1; Shields, Troy G. MD1; Morrison, Martin J. III MD1

doi: 10.2106/JBJS.CC.18.00391
Case Reports

Case: Focal periphyseal edema (FOPE) zones have only recently been described as a cause of joint pain in adolescence. The literature is limited to a few case reports and radiologic studies describing this symptomatic physeal pathology. This series describes 3 adolescent patients with magnetic resonance imaging (MRI) confirmed FOPE zones of the distal femur. Repeat MRI of 2 of the 3 patients showed improvement yet incomplete resolution of the bone edema, corresponding with persistent knee pain.

Conclusions: FOPE zones usually improve with conservative treatment, but may be a cause of persistent knee pain in adolescents.

1Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, California

E-mail address for J.N. Speirs:

Investigation performed at Loma Linda University, Loma Linda, California

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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