The growth of long bones is a result of a precisely orchestrated and tightly regulated series of biological steps that culminate in the formation of a calcified cartilage matrix that is
subsequently resorbed and replaced by lamellar bone. The regulation of these critical cellular events occurs through integration of signals from both systemic hormones and locally
produced growth factors that are subsequently relayed to the nucleus and converted into alterations in gene expression. Elucidation of the cellular and molecular pathways that regulate the process of endochondral ossification at the growth plate is an obligatory step in devising rational treatment strategies that will address the myriad of genetic, developmental, and traumatic abnormalities of growth plate function that occur in children.