Ultraschall Med 2016; 37 - SL3_1
DOI: 10.1055/s-0036-1587723

Pediatric musculoskeletal ultrasound – age- and sex-related normal B-mode findings of the knee

D Windschall 1, R Trauzeddel 2, M Haller 3, M Krumrey-Langkammerer 4, A Nimtz-Talaska 5, R Berendes 6, G Ganser 7, C Nirschl 8, P Schoof 9, RF Trauzeddel 10, K Palm-Beden 7, H Lehmann 11
  • 1Asklepios Klinikum Weissenfels, Kinder- und Jugendmedizin, Weissenfels, Germany
  • 2Helios Klinikum Berlin-Buch, Department of Pediatric Rheumatology, Berlin, Germany
  • 3Practice for Pediatrics and Pediatric Rheumatology, Gundelfingen, Germany
  • 4German Center for Pediatric Rheumatology, Garmisch-Partenkirchen, Germany
  • 5Practice for Pediatrics and Pediatric Rheumatology, Frankfurt (Oder), Germany
  • 6St. Marien Children"s Hospital, Landshut, Germany
  • 7Clinic for Pediatric Rheumatology St. Josef Stift, Sendenhorst, Germany
  • 8Asklepios Klinikum Weissenfels, Weissenfels, Germany
  • 9Practice for Pediatrics and Pediatric Rheumatology, Munich, Germany
  • 10Charité University Medicine, Berlin, Germany
  • 11Clinic for Pediatrics and Neonatology, Justus Liebig-University Gießen, Gießen, Germany

Purpose: Musculoskeletal ultrasound (MSUS) is an important tool for evaluating disease activity, therapeutic progress, and remission status of rheumatic diseases in children. Knowledge of age-related normal findings is essential when interpreting pathological findings such as those seen in juvenile idiopathic arthritis. The most commonly affected joint in childhood arthritis is the knee.

Material and methods: To evaluate normal findings of the knee joint, we recorded age-related stages of musculoskeletal development in the knee in 440 healthy children between 1 and 18 years of age using high-resolution B-mode MSUS. We determined approximate age- and sex-related norms for suprapatellar recess size, ossified patella size, and distal femoral intercondylar cartilage thickness.

Results: In almost all age groups, over 64% of children had visible fluid accumulation in the suprapatellar recess. Significant correlations were found between chronological age and the size of the suprapatellar recess and the length of the ossified patella (p < 0.05). An age-dependent decrease in intercondylar cartilage thickness of the distal femoral epiphysis was found in children between 10 and 18 years of age.

Conclusion: High-resolution B-mode MSUS is an excellent tool for assessing joint and skeletal development in children. Our reference data can be used to discriminate better between normal physiological findings and pathological abnormalities.

Fig. 1: Measurement of ossified patella