Pediatric Radiology

, Volume 49, Issue 12, pp 1617–1628 | Cite as

Normal development imaging pitfalls and injuries in the pediatric shoulder

  • Jonathan ZemberEmail author
  • Pedro Vega
  • Ignacio Rossi
  • Zehava Sadka Rosenberg
Musculoskeletal imaging


The skeletal maturation of the shoulder has been well documented on radiographic and cadaveric studies. Recent increased use of MRI has provided increased understanding of the soft-tissue and osseous changes that occur during development. Thus recognizing normal maturation, imaging manifestations and pitfalls is crucial when evaluating the pediatric shoulder joint. At birth, the humeral diaphysis, midportion of the clavicle, and the body of the scapula are ossified, while the remainder of the bones of the shoulder are composed of non-ossified cartilaginous precursors. During growth, cartilaginous apophyses and epiphyses of the shoulder develop numerous secondary ossification centers, which fuse with the primary ossification centers to form the complete bony components of the shoulder. Additionally changes in the morphology of the growth plates as well as marrow signal occur in an organized manner. This paper affords the reader with an understanding of the normal development of three major components of skeletal maturation in the shoulder: ossification centers, growth plates and marrow signal. These topics are further subdivided into the glenoid, proximal humerus and acromioclavicular joint. We also provide a focus on distinguishing normal anatomy from imaging pitfalls related to skeletal maturation.


Children Computed tomography Development Magnetic resonance imaging Pitfalls Radiography Shoulder Trauma 


Compliance with ethical standards

Conflicts of interest



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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of RadiologyChildren’s National Medical CenterWashingtonUSA
  2. 2.Centro de Diagnostico Dr. Enrique RossiBuenos AiresArgentina
  3. 3.Department of RadiologyNYU Langone Medical CenterNew YorkUSA

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