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The roles of radiography, ultrasound, MRI, and CT are discussed, with case-based illustrations highlighting key diagnostic features and potential pitfalls.<\/jats:p>","DOI":"10.1055\/a-2960-2364","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:05:51Z","timestamp":1790809551000},"source":"Crossref","is-referenced-by-count":0,"title":["Chronic Overuse Injuries of the Lower Extremity in Young Athletes: Imaging Features and Diagnostic Considerations"],"prefix":"10.1055","author":[{"given":"Eduardo","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason Zarahi","family":"Amaral","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Texas, United States","place":["Houston"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5009-3925","authenticated-orcid":false,"given":"Rida","family":"Salman","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital and The Ohio State University College of Medicine, Ohio, United States","place":["Columbus"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"e763","DOI":"10.1097\/BPO.0000000000002757","article-title":"Incidence of tibial tubercle fractures in patients with and without Osgood-Schlatter disease","volume":"44","author":"J D Milner","year":"2024","journal-title":"J Pediatr Orthop"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1177\/03635465241277162","article-title":"Prevalence of abnormalities and normal variants in the adolescent knee on MRI in a population-based cohort of 3800 knees","volume":"52","author":"L AM Kemmeren","year":"2024","journal-title":"Am J Sports Med"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1007\/s00264-020-04572-3","article-title":"Conservative treatment of Osgood-Schlatter disease among young professional soccer players","volume":"44","author":"E N Bezuglov","year":"2020","journal-title":"Int Orthop"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s12306-017-0479-7","article-title":"Treatment of Osgood-Schlatter disease: review of the literature","volume":"101","author":"E Circi","year":"2017","journal-title":"Musculoskelet Surg"},{"issue":"09","key":"ref5","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1007\/s004020100285","article-title":"Ultrasonography as a diagnostic modality in Osgood-Schlatter disease. 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sleeve fractures and other inferior pole pathologies","volume":"50","author":"S K Devana","year":"2022","journal-title":"Am J Sports Med"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"e064903","DOI":"10.1136\/bmjopen-2022-064903","article-title":"Risk factors and associated factors for calcaneal apophysitis (Sever's disease): a systematic review","volume":"13","author":"P Nieto-Gil","year":"2023","journal-title":"BMJ Open"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/BPB.0b013e32833a5fa7","article-title":"Can we make a diagnosis with radiographic examination alone in calcaneal apophysitis (Sever's disease)?","volume":"19","author":"O Kose","year":"2010","journal-title":"J Pediatr Orthop B"},{"issue":"08","key":"ref14","first-page":"801","article-title":"Ultrasonography of the calcaneus in Sever's disease","volume":"42","author":"B Ho\u015fg\u00f6ren","year":"2005","journal-title":"Indian 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