This Issue's Rounds Question - " Tell us about Concavity compression " (responses to be published in next issue)

In the last issue of Body Cast, Rounds asked:
“What is the Harris Growth Arrest Line?”

The following responses were received:

From Edward Clancey:

Many bones exhibit transversely oriented, dense trabecular bone patterns within the metaphysic. These usually duplicate the contiguous physeal contour. They may appear after trauma, particularly when the child has been immobilized in bed (traction for femoral fracture), and also may appear after generalized illness or even localized processes within the bone (e.g., osteomyelitis). The lines result from a temporary slowdown of normal longitudinal growth rates during the injury period or illness, and often are referred to as Harris growth slowdown, the trabeculae of the primary spongiosa become more transversely than longitudinally oriented, creating temporary thickening in the primary spongiosa adjacent to the physis. Once the normal longitudinal growth rate resumes, longitudinal trabecular orientation is restored. The thickened transverse osseous plate is “left behind” to be gradually remodelled as primary spongiosa becomes secondary spongiosa.

From Jean Hohs:

Dense lines, parallel to the growth plates of long bones, seen on radiographs, represent temporary slowing or cessation of longitudinal growth. These lines are also known as stress lines, transverse lines, or Park lines. Some feel “growth recovery lines” are a more accurate name as they appear to be formed during periods of renewed growth following a period of growth arrest.

These lines are associated with periods of childhood stress, infection, trauma or dietary restriction.

From Lori MacDonald and Blair Matheson:

Named after Henry Harris, Welsh anatomist, Harris growth arrest lines are dense trabecular transversely oriented lines with the metaphysic, commonly seen in children of all ages. These lines, also called recovery lines, follow a period of illness or immobilization. These lines relate to a temporary slowdown of a longitudinal growth. These lines are usually symmetrical and are most prominent in rapidly growing metaphyses, e.g. distal femur and proximal tibia. With further growth, they become incorporated into the diaphysis and disappear with endosteal remodelling. Analysis of these lines on radiographs may be useful to corroborate overgrowth of the affected limb post fracture. A line that converges towards the physis suggests localized growth damage and may predict the development of a physeal bar and deformity.

From Cheryl Rivers:

A Harris growth arrest line pertains to children/teens in whom the bone lines show retarded growth, usually due to trauma to a bone. According to Blaukett-Nelson, a Harris line is a straight, thin radiodense line across the metaphysic of bone resulting from a previous change in the growth rate of that bone, most commonly seen after a fracture, also called a growth arrest line.

Responses were also received from Livain Arseneau, Lynn Arseneau, Bernie Arseneault, Tony Bellon, Tom Broughton, Lhea Burk, Eric Christiansen, Adrian Crossman, Paul Gaudet, Richard Grenier, Suzanne Groulx, Edd Hayes, Leo Helfer, Roger Ip Fung Chun, Mary Anne Lash, Brian Lavallee, Cam Longphee, Jacques Mayer, GaryMarshall, Joe Mauluccie, Mary Perkins, James Punwassie, Vital Robichaud, Elizabeth Seguin, bert Sheppard, Mark Unger, Angela Wentzell, Joan Wilson, Healther Wong, Neuville Yao, Tom Yorke and Mary Young.