Artikel
Proof of concept – study for the evaluation of healthy joints and periarticular structures in children
Suche in Medline nach
Autoren
Veröffentlicht: | 29. August 2016 |
---|
Gliederung
Text
Background: Musculoskeletal ultrasonography (MSUS) has become an important diagnostic tool for the diagnosis and follow-up of inflammatory joint diseases in children, especially in juvenile idiopathic arthritis (JIA). However, only few studies on a small number of patients are available so far, producing an immanent need for further knowledge on the ultrasonographic appearance of periarticular and joint structures in healthy children. This is especially true for the presence of Power Doppler activity in healthy joints.
The aim of the study was to evaluate normal values for the thickness of healthy joint cartilage, capsule and tendons of the hand (finger/wrist), elbow, hip, knee, ankle and forefoot in children by musculoskeletal ultrasound (US). More over, the question about the presence of Power Doppler activity in healthy joints was addressed.
Methods: Four MSUS experienced OMERACT MSUS SIG sonographers used 4 equally preset Esaote Mylab Twice machines, 13-18 MHz probes, to examine N=75 healthy children (34 girls), 4.3-13.1 years old, who have successfully passed a detailed health questionnaire assuring the lack of underlying pathology.
Statistics: for the standard reference intervals normal or lognormal distributions were assessed and calculated with Shapiro-Wilk W Test / Kolmogorov's D test.
Results: In most joints a relatively wide range of the measurements of periarticular and joint structures was found with a geometrical mean between 0.54 and 4.59. In younger children the range was even wider. PDUS signals were commonly detectable in all joints, predominantly in wrist, finger and knee joints.
Conclusion: The reference intervals for healthy children are needed for the interpretation of pathological findings in JIA. Due to the wide range in both grey scale and PDUS, pathology should be examined carefully in terms of under-/overinterpretation. Especially in younger children, joint measurements might have different values due to the growing structures, which need further evaluation.