Symptomatic radiographic variants in extremities.

Three groups of apparently normal developmental variants in extremities as they appear on radiographs are presented. In contrast to the widely held view that these are of no clinical significance, these ossicles may, in fact, be responsible for symptoms. The first group consists of ossicles which, from the very onset, may represent the sequelae of repetitious trauma. The second group is composed of normal variants in which the presence of a congenital synchondrosis may predispose to injury as a result of chronic repetitious trauma. The third group consists of ossicles that may result in local and premature degenerative changes. The use of radionuclide bone scanning, which provides physiologic as well as morphologic information, is crucial in evaluating the significance of these ossicles in the symptomatic patient.