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Fig. 5. —12-year-old boy 5 months after distal tibial Salter-Harris type 2 fracture. Coronal T1-weighted MR image (TR/TE, 300/14) reveals lateral triangular-shaped area of peripheral low-signal-intensity sclerosis (black arrows) and central high-signal-intensity fatty marrow (white arrows) that corresponded to Thurston Holland metaphyseal fragment at time of fracture. This is typical appearance of avascular necrosis in devascularized metaphyseal fracture fragment. Large bridge involving entire medial physis was shown on gradient-recalled echo images (not shown).