{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:51:36Z","timestamp":1791366696898,"version":"4.3.1"},"reference-count":63,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The incidence of pediatric overuse injuries is increasing in proportion to rising participation and training intensity in youth sports worldwide. The growing musculoskeletal system of children and adolescents makes them susceptible to a unique type of injuries which differ from those in a mature skeleton and requires specific knowledge about normal physiology and imaging manifestations of injuries. The most common overuse injuries in children include stress fractures, traction apophysitis, and repetitive physeal injuries. Less commonly, osteochondral lesions, impingement syndromes, and tendinopathies may also occur. Additionally, several conditions, including normal developmental variants or diseases like chronic nonbacterial osteomyelitis and osteoid osteoma, can mimic overuse injuries in the pediatric skeleton and must be recognized to avoid diagnostic errors. The imaging approach to overuse injuries in children should be precise and prioritize safe imaging modalities\u2014magnetic resonance imaging and ultrasound\u2014to prevent unnecessary radiation exposure. In this review article, we will emphasize the imaging approach and features of relatively common overuse injuries of the growing skeleton, as well as conditions that may mimic an injury.<\/jats:p>","DOI":"10.1055\/a-2912-2807","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:53:41Z","timestamp":1789426421000},"page":"639-653","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Overuse Injuries"],"prefix":"10.1055","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7208-8097","authenticated-orcid":false,"given":"Adalet Elcin","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Hacettepe University, School of Medicine, T\u00fcrkiye","place":["Ankara"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1085-8978","authenticated-orcid":false,"given":"Zeynep Maras","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Ankara Guven Hospital, T\u00fcrkiye","place":["Ankara"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8919-183X","authenticated-orcid":false,"given":"Neslihan","family":"Ta\u015fdelen","sequence":"additional","affiliation":[{"name":"HSM Imaging Center, T\u00fcrkiye","place":["Istanbul"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.yapd.2012.04.005","article-title":"Pediatric overuse injuries in sports","volume":"59","author":"Q B Hoang","year":"2012","journal-title":"Adv Pediatr"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s40621-021-00344-8","article-title":"An epidemiologic comparison of acute and overuse injuries in high school sports","volume":"8","author":"E E Ritzer","year":"2021","journal-title":"Inj Epidemiol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s40134-014-0045-0","article-title":"MRI of sports injuries in children and adolescents: what's different from adults","volume":"2","author":"C Bateni","year":"2014","journal-title":"Curr Radiol Rep"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/RMR.0000000000000048","article-title":"Overuse injuries in children","volume":"24","author":"M A Bedoya","year":"2015","journal-title":"Top Magn Reson Imaging"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5334\/jbsr.4198","article-title":"Zero echo time MRI for osseous assessment of sports-related pathology in athletes: a pictorial essay","volume":"110","author":"D F Hanff","year":"2026","journal-title":"J Belg Soc 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Omar","year":"2008","journal-title":"Radiographics"},{"issue":"05","key":"ref45","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s00256-016-2340-8","article-title":"Sonographic evaluation of athletic pubalgia","volume":"45","author":"N Morley","year":"2016","journal-title":"Skeletal Radiol"},{"issue":"06","key":"ref46","doi-asserted-by":"crossref","first-page":"566","DOI":"10.5152\/dir.2016.16143","article-title":"MRI of lower extremity impingement and friction syndromes in children","volume":"22","author":"\u00dc Ayd\u0131ng\u00f6z","year":"2016","journal-title":"Diagn Interv Radiol"},{"issue":"S 01","key":"ref47","doi-asserted-by":"crossref","first-page":"S126","DOI":"10.1097\/BPO.0b013e318274f834","article-title":"Hip arthroscopy and femoroacetabular impingement in the pediatric patient","volume":"33","author":"M J Philippon","year":"2013","journal-title":"J Pediatr 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