A Cross-Sectional Magnetic Resonance Imaging Study of Factors Influencing Growth Plate Closure in Adolescents and Young Adults.

AIM To assess growth plate fusion by Magnetic Resonance Imaging (MRI) and evaluate the correlation with sex, age, pubertal development, physical activity and BMI. METHODS Wrist, knee and ankle of 958 healthy subjects aged 14.0-21.5 years old were examined using MRI and graded by two radiologists. Correlations of growth plate fusion score with age, pubertal development, physical activity and BMI was assessed. RESULTS Complete growth plate fusion occurred in 75, 85, 97, 98, 98% and 90, 97, 95, 97, 98% (radius, femur, proximal- and distal tibia and calcaneus) in 17-year-old females and 19-year-old males, respectively. Complete fusion occurs approximately 2 years earlier in girls than in boys. Pubertal development correlated with growth plate fusion score (rho= 0.514-0.598 for the different growth plate sites) but regular physical activity did not. BMI also correlated with growth plate fusion (rho= 0.186-0.384). Stratified logistic regression showed increased odds ratio (OR F: 2.65- 8.71; M: 1.71- 4.03) for growth plate fusion of obese or overweight compared normal weight subjects. Inter-observer agreement was high (Κ= 0.87-0.94). CONCLUSION Growth plate fusion can be assessed by MRI and occurs in an ascending order, from the foot to the wrist, and is significantly influenced by sex, pubertal development and BMI, but not by physical activity.