The blood supply of early, late, and nonossifying cartilage: preliminary gray-scale and Doppler assessment and their implications

Background Comparative gray-scale Doppler US studies of various cartilages have not been reported before. Objective To study gray-scale US and perfusion patterns of different cartilages. Materials and methods Three groups of cartilages were studied in 42 normal neonates. Group A included the proximal femoral chondroepiphysis of 20 neonates as well as proximal humeral, distal femoral, and proximal tibial epiphyses of 8 others. Group B included the patellar cartilage of nine neonates and group C included the rib cartilage of five neonates. Results Early ossifying cartilages all had numerous echogenic columns on US. Late ossifying patellar cartilage was amorphous and hypoechoic at birth but contained echogenic columns near the ossification age. Rib cartilage was hypoechoic and amorphous at all ages. The blood supply was detectable in all cartilages except the ribs. Peak systolic velocities increased with age in the proximal femoral epiphysis. The patellar cartilage was less vascular than the distal femoral epiphysis at birth, but more vascular at 14–24 months of age. The rib cartilage did not have any discernable blood supply at any age. Conclusions Cartilage blood flow is detectable with current technology. Cartilage blood flow correlates with the timing of its ossification. Normal cartilage blood flow may prognosticate normality of its growth and development potential.