Growth Plate

Aka: Growth Plate, Physis, Ossification Center, Epiphyseal Line, Epiphyseal Plate, Bone Collar, Periosteal Bud, Long Bone Growth, Bone Development

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II. Physiology: Bone Development from Cartilage

  1. Hyaline Cartilage
    1. Hyaline cartilage is the initial structure or mold into which bone forms
  2. Bone Collar
    1. Forms along the outer margin of the bone (at future diaphysis)
  3. Primary Ossification Center
    1. Hyaline cartilage deteriorates and cavitates centrally forming a hyaline cavity
  4. Medullary (central) spongy bone formation
    1. Spongy bone forms centrally from primary Ossification Center
  5. Periosteal Bud
    1. Vascular connective tissue from the perichondrium (outer margin) invades central hyaline cavity
    2. Forms future blood supply to Medullary cavity
  6. Medullary cavity
    1. Bony cavity replaces prior hyaline cartilage cavity
  7. Secondary Ossification Center
    1. Spongy bone forms from secondary Ossification Center (at each long bone end)
    2. Develops into epiphyseal bone
  8. Epiphyseal Plate cartilage (epiphysis or Growth Plate)
    1. Cartilage remains between bone formed from primary (central) and secondary (epiphyseal) Ossification Centers
    2. Remaining cartilage functions as a Growth Plate for Long Bone Growth
  9. Articular cartilage
    1. Hyaline cartilage remains at the long bone ends at joint margins
    2. All other hyaline cartilage is replaced by bone, aside from at the epiphysis

III. Physiology: Growth Plate (Physis)

  1. Long bones (e.g. femur, Humerus) in children contain 2 Growth Plates, one at each end
  2. Growth Plates are composed cartilage, which is in turn produced by chondrocytes
  3. Chondrocytes progress through 5 development stages, as they migrate from epiphysis to metaphysis
    1. See Growth Plate Layers below
  4. Growth Plate closure (fusion)
    1. Chondrocytes die
    2. Cartilage is replaced with mature bone (Endochondral ossification)
    3. Long Bone Growth ceases
    4. Growth Plate scar remains visible on XRay
  5. Growth Plate (Physis) blood supply
    1. Most of the Growth Plate perfusion is from the epiphysis
      1. First 2 Growth Plate layers (Resting and Proliferative Zones) are supplied by the epiphysis
      2. Hypertrophic zone is avascular compared with other layers
      3. Interrupted epiphyseal vascular supply to the Physis (Fracture) risk delayed Fracture healing and complications
    2. Other Growth Plate vascular supply
      1. Metaphyseal vessels (supplies endochondral ossification, region of cartilage replaced with bone)
      2. Perichondral ring of LaCroix (supplies the peripheral aspects of the Physis)
  6. Growth Plate closure
    1. Growth Plate closure is earlier in females
      1. Triggered by increased circulating Estrogen levels with Puberty
    2. Distal tibia and fibula Growth Plate closure
      1. Male: 14 to 19 years
      2. Female: 12 to 16 years
    3. Distal radius Growth Plate closure
      1. Male: 19 years
      2. Female 18 years

IV. Anatomy: Growth Plate Layers (in the context of other bone regions)

  1. Articular cartilage of joint
  2. Epiphysis (rounded bone end)
  3. Epiphyseal Plate or Growth Plate (Hyaline Cartilage)
    1. Resting Zone (or Reserve Zone)
      1. Colloid matrix of vessels and germinal cells (chrondrocyte progenitors)
      2. Vessels (from the epiphysis) are the primary blood supply to the Growth Plate
      3. Chondrocytes differentiate from germinal cells, and remain in a resting state
    2. Proliferating Zone (or proliferative zone)
      1. Chondrocytes (formed in the reserve zone) undergo Mitosis after migrating to proliferating zone
      2. Chondrocyte organize into columns of a proteoglycan matrix
    3. Hypertrophic Zone
      1. Maturation Zone
        1. Chondrocytes further differentiate and increase in size throughout the Hypertrophic Zone
        2. Chrondrocytes also produce Collagen, glycogen, lipids and Alkaline Phosphatase
      2. Degenerative Zone
      3. Provisional Calcification Zone (or calcified zone)
        1. Least resistant to stress and greatest risk for Fractures
        2. Transition between calcified and non-calcified extracellular matrix Proteins
        3. Final layer of the Physis, in which colloid matrix calcifies and chondrocytes die
          1. Chondrocyte death allows for ostocytes to enter and osteogenesis begins
  4. Metaphysis
    1. Primary Spongiosa
    2. Secondary Spongiosa
  5. Diaphysis

V. References

  1. Sanghani, Kern and Mehta (2025) Crit Dec Emerg Med 39(2): 27-35
  2. Agirdil (2020) EFORT Open Rev 5(8):498-507 +PMID: 32953135 [PubMed]

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Related Studies

Ontology: Bone Development (C0005939)

Definition (GO) The process whose specific outcome is the progression of bone over time, from its formation to the mature structure. Bone is the hard skeletal connective tissue consisting of both mineral and cellular components. [GOC:dph]
Definition (MSH) The growth and development of bones from fetus to adult. It includes two principal mechanisms of bone growth: growth in length of long bones at the epiphyseal cartilages and growth in thickness by depositing new bone (OSTEOGENESIS) with the actions of OSTEOBLASTS and OSTEOCLASTS.
Definition (CSP) growth and development of bones from fetus to adult; includes two principal mechanisms of bone growth, which are growth in length of long bones at the epiphyseal cartilages, and growth in thickness by depositing new bone; see also OSTEOGENESIS.
Concepts Organ or Tissue Function (T042)
MSH D001846
SnomedCT 83323007
English Bone Development, bone development, development bone, bones development, Bone development, Bone development, NOS
Swedish Benutveckling
Finnish Luuston kehitys
French Développement squelettique, Développement des os, Développement osseux, Développement du squelette
Russian KOSTI RAZVITIE, КОСТИ РАЗВИТИЕ
Croatian KOŠTANI RAZVOJ, RAZVOJ KOSTI, KOST, RAZVOJ
Polish Rozwój kości
Japanese 骨成長, 骨発育
Czech kosti - vývoj, vývoj kostí
Spanish desarrollo óseo, Desarrollo Óseo
German Knochenentwicklung
Italian Sviluppo osseo
Dutch Botvorming, Vorming, bot-
Portuguese Desenvolvimento Ósseo
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Epiphysial cartilage (C0018283)

Definition (MSH) The area between the EPIPHYSIS and the DIAPHYSIS within which bone growth occurs.
Concepts Tissue (T024)
MSH D006132
SnomedCT 49811003, 84349008
English Epiphyseal Plate, Epiphyseal Plates, Growth Plate, Growth Plates, Plate, Epiphyseal, Plate, Growth, Plates, Epiphyseal, Plates, Growth, Lamina epiphysialis, Growth plate of long bone, epiphyseal growth plates, epiphyseal growth plate, epiphyseal plates, long bone growth plate, physis, epiphyseal plate, growth plates, growth plate, Epiphyseal cartilage (body structure), Epiphyseal cartilage, Growth plate, Epiphyseal growth plate, Epiphyseal plate, Epiphysial plate, Cartilago epiphysialis, Epiphyseal plate (body structure), Physis, Epiphyseal growth plate, NOS, Physis, NOS, Epiphyseal cartilage -RETIRED-, Cartilage, Epiphyseal, Cartilages, Epiphyseal, Epiphyseal Cartilage, Epiphyseal Cartilages, Epiphysial cartilage
French Lame épiphysaire, Cartilage épiphysaire, Cartilage de croissance, Cartilage de conjugaison, Cartilage diaphysoépiphysaire
Swedish Tillväxtplatta
Finnish Kasvulevy
Italian Cartilagine epifisiale, Cartilagine di accrescimento
Russian EPIFIZARNAIA ZONA ROSTA, KHRIASHCH EPIFIZARNYI, EPIFIZARNYI KHRIASHCH, EPIFIZARNAIA ROSTOVAIA PLASTINKA, ROSTA ZONA EPIFIZARNAIA, РОСТА ЗОНА ЭПИФИЗАРНАЯ, ХРЯЩ ЭПИФИЗАРНЫЙ, ЭПИФИЗАРНАЯ ЗОНА РОСТА, ЭПИФИЗАРНАЯ РОСТОВАЯ ПЛАСТИНКА, ЭПИФИЗАРНЫЙ ХРЯЩ
Japanese 軟骨-骨端, 成長板, 骨端軟骨
Croatian EPIFIZNA HRSKAVICA
Czech růstová ploténka, epifýzodiafyzární ploténka
Polish Chrząstka nasadowa
Norwegian Vekstsone, Vekstbrusk, Epifysebrusk
Spanish cartílago epifisario, cartílago epifisario (concepto no activo), Cartílago de Crecimiento, cartílago de crecimiento epifisario, fisis, placa de crecimiento epifisario (estructura corporal), placa de crecimiento epifisario, Placa de Crecimiento, Placa Epifisaria, Cartílago Epifisario
Portuguese Cartilagem de Crescimento, Placa de Crescimento, Cartilagem Epifisial, Lâmina de Crescimento, Lâmina Epifisial
German Epiphysenplatte, Wachstumsfuge
Dutch Epifysaire schijf, Epifysiar kraakbeen, Groeischijf, Kraakbeen, epifysiar
Derived from the NIH UMLS (Unified Medical Language System)

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