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11-07-2016 | Juvenile idiopathic arthritis | Article

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

Rheumatology International

Authors: Daniel Windschall, Ralf Trauzeddel, Maria Haller, Manuela Krumrey-Langkammerer, Antje Nimtz-Talaska, Rainer Berendes, Gerd Ganser, Christine Nirschl, Philipp Schoof, Ralf Felix Trauzeddel, Katharina Palm-Beden, Hartwig Lehmann, on behalf of the Imaging Working Group of the German Society of Rheumatology in Childhood and Adolescense (GKJR)

Publisher: Springer Berlin Heidelberg


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. To evaluate normal findings of the knee joint, we recorded age-related stages of musculoskeletal development in the knee of 435 healthy children between 1 and 18 years of age using high-resolution B-mode MSUS. We determined approximate age- and sex-related norms for the suprapatellar recess size, ossified patella size, and distal femoral intercondylar cartilage thickness. 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 suprapatellar recess size and ossified patella length (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. 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.

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