Salter-Harris type I is a transverse fracture through the physis. Widening of the growth plate may be seen on initial films and soft tissue swelling should be present.  Comparison views of the unaffected side may aid diagnosis.  Repeat films in 7-10 days should show adjacent sclerosis and periosteal reaction.  Initially swelling and tenderness over a growth plate after trauma even with normal films should lead to an initial diagnosis of a probable type I fracture.

     Salter-Harris type II is  through the physis and metaphysis, sparing the epiphysis.  Diagnosis is made by noting the metaphyseal fragment (the Thurston-Holland fragment) on x ray.

     Salter-Harris type III fractures extend through the physis and epiphysis, creating an intraarticular fracture.

     Salter-Harris type IV fractures extend through the physis and both metaphysis and epiphysis, again creating an intraarticular fracture.

     Salter-Harris type V is a compression fracture of the physis that is difficult to visualize radiologically because of the lack of a bony fracture line.  The key to diagnosis is a history of an axial load with soft tissue swelling and tenderness at the physis.  Comparison views of the unaffected side may aid diagnosis. Type V fractures are often diagnosed retrospectively when shortening secondary to premature growth cessation is apparent.