Focal Periphyseal Edema (FOPE) Zone: A Possible Cause of Unexplained Knee Pain In Adolescents. A Case Report and Literature Review.
Article Sidebar
Main Article Content
Abstract
Focal periphyseal edema (FOPE) is a recently described condition seen on Magnetic Resonance Imaging (MRI) scans of adolescent patients in relation to knee pain. Since its description in 2011, and proposal as a possible reason for adolescent knee pain, few case series have been published. We report a case of an adolescent male with activity-related knee pain and FOPE finding on MRI scan of his knee. On reviewing medical literature we found nine case series reported with regards to FOPE zone. We have reviewed the demographic and clinical characteristics of the reported cases. With this report we aim to bring more awareness about this condition amongst orthopedic surgeons.
Article Details
This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
Zbojniewicz AM, Laor T. Focal Periphyseal Edema (FOPE) zone on MRI of the adolescent knee: a potentially painful manifestation of physiologic physeal fusion? AJR Am J Roentgenol. 2011;197(4):998-1004
Beckmann N, Spence S. Unusual presentations of focal periphyseal edema zones: a report of bilateral symmetrical presentation and partial physeal closure. Case Rep Radiol. 2015;2015:465018:1-8
Bochmann T, Forrester R, Smith J. Case report: imaging the clinical course of FOPE: a cause of adolescent knee pain. J Surg Case Rep. 2016;11:1-2
Bai RJ, Zhan HL, Lui Y, et al. Focal periphyseal edema zone on MRI and clinical significance of the adolescent knee [in Chinese]. Zhonghua Yi Xue Za Zhi. 2016;96(25):1965-70
Sakamoto A, Matsuda S. Focal periphyseal edema zone on magnetic resonance imaging in the greater trochanter apophysis: a case report. J Orthop Case Rep. 2017;7(4):29-31
Giles E, Nicholson A, Sharkey MS, et al. Focal periphyseal edema: are we overtreating physiologic adolescent knee pain? J Am Acad Ortho Surg Glob Res Rev 2018;2(4):e047
Ueyama H, Kitano T, Nakagawa K, et al. Clinical experiences of focal periphyseal edema zones in adolescent knees: case reports. J Pediatr Orthop B. 2018;27(1):26-30
Speirs JN, Shields TG, Morrison III MJ. Focal periphyseal edema: an uncommon cause of adolescent knee pain. A report of three cases. JBJS Case Connect 2019;9:e0391
Frohlich S, Peterhans L, Stern C, et al. Remarkably high prevalence of overuse-related knee complaints and MRI abnormalities in youth competitive alpine skiers: a descriptive investigation in 108 athletes aged 13-15 years. BMJ Open Sport & Exercise Medicine 2020;6:e000738. doi:10.1136/bmjsem-2020-000738