Structural ultrasound of joints and tendons in healthy children: development of normative data
Abstract Background Musculoskeletal ultrasound is a well accessible technique to assess disease activity in children with juvenile idiopathic arthritis. Knowledge of reference values of joint structures is indispensable to differentiate between physiological and pathological finding. The aim of this...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Pediatric Rheumatology Online Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12969-023-00895-8 |
| _version_ | 1797577500969140224 |
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| author | Ruth Wittoek Céline Decock Nele Dewaele Lara Arnold Pieter Baeyens Ignace De Schrijver Lisa Pardaens Ioannis Raftakis Thomas Renson Charline Rinkin Alexander D. J. Thooft Tine Vanhaverbeke Caroline Verbist |
| author_facet | Ruth Wittoek Céline Decock Nele Dewaele Lara Arnold Pieter Baeyens Ignace De Schrijver Lisa Pardaens Ioannis Raftakis Thomas Renson Charline Rinkin Alexander D. J. Thooft Tine Vanhaverbeke Caroline Verbist |
| author_sort | Ruth Wittoek |
| collection | DOAJ |
| description | Abstract Background Musculoskeletal ultrasound is a well accessible technique to assess disease activity in children with juvenile idiopathic arthritis. Knowledge of reference values of joint structures is indispensable to differentiate between physiological and pathological finding. The aim of this study was to assess the structural sonographic features of joints and tendons in healthy children from several age groups (0.2–18 year), and develop a set of normative data. Methods Greyscale ultrasound was performed in 500 healthy children (age 0.2–18 years) according to a predefined scanning protocol (Additional file 1) including the shoulder, elbow, wrist, second metacarpophalangeal joint, hip, knee, ankle, and first metatarsophalangeal joint). Demographic data and values of cartilage thickness, tendon diameters, and the degree of capsular distention measured by bone-capsular distance (BCD) were collected. Differences according to the sex were assessed by unpaired t-test. Single and multiple regression analyses were performed between the ultrasound outcomes and covariates such as age, height, weight and body mass index. Growth charts and tables were developed with respect to age. Nonparametric quantile regression was applied using the R-packages quantreg and quantregGrowth. Results A total of 195 male and 305 female volunteers were included between the age of 0 and 18 years (mean age 8.9; range: 0.2–17.9 years). Cartilage diminished markedly as children aged, and cartilage of the boys was significantly thicker compared to the girls in all joints (p < 0.001). In addition, cartilage became thinner as children’s height and weight increased (beta regression coefficients between − 0.27 and − 0.01, p < 0.0001). Capsular distention (i.e., BCD > 0 mm) was uncommon in the ankle, wrist and MCP2 (resp. in 3, 6, and 3% of cases). It was more common in the suprapatellar and parapatellar knee, MTP1 and posterior recess of the elbow (resp. in 34, 32, 46, and 39% of cases). In the hip, some capsular distention was always present. Age was found to be the best predictor for BCD (beta regression coefficients between 0.05 and 0.13, p < 0.0001). Height was, in addition to age, a good predictor of tendon diameter (beta regression coefficients between 0.03 and 0.14, p < 0.0001). Growth curves and tables for each variable were developed. Conclusions Reference values of sonographic cartilage thickness, BCD and diameters of tendons at several joints were established from 500 healthy children, aged between 0.2 and 18 years. Growth charts and tables were developed to distinguish normal findings from pathology in children with complaints suspicious of arthritis. |
| first_indexed | 2024-03-10T22:09:12Z |
| format | Article |
| id | doaj.art-40b13a976b3a4c129d137ce287a77961 |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-03-10T22:09:12Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-40b13a976b3a4c129d137ce287a779612023-11-19T12:40:04ZengBMCPediatric Rheumatology Online Journal1546-00962023-09-012111810.1186/s12969-023-00895-8Structural ultrasound of joints and tendons in healthy children: development of normative dataRuth Wittoek0Céline Decock1Nele Dewaele2Lara Arnold3Pieter Baeyens4Ignace De Schrijver5Lisa Pardaens6Ioannis Raftakis7Thomas Renson8Charline Rinkin9Alexander D. J. Thooft10Tine Vanhaverbeke11Caroline Verbist12Rheumatology, Ghent University HospitalFaculty of Medicine and Health Sciences, Dept. of Internal Medicine and Pediatrics, Ghent UniversityFaculty of Medicine and Health Sciences, Dept. of Internal Medicine and Pediatrics, Ghent UniversityRheumatology, AZ Sint-Lucas GentRadiology, Clinique de FlandreRadiology, Clinique de FlandreRheumatology, Ghent University HospitalRheumatology, CHU-Brugmann Hospital BrusselsFaculty of Medicine and Health Sciences, Dept. of Internal Medicine and Pediatrics, Ghent UniversityRheumatology, CHU LiègeFaculty of Medicine and Health Sciences, Dept. of Internal Medicine and Pediatrics, Ghent UniversityRheumatology, Ghent University HospitalRheumatology, AZ DeltaAbstract Background Musculoskeletal ultrasound is a well accessible technique to assess disease activity in children with juvenile idiopathic arthritis. Knowledge of reference values of joint structures is indispensable to differentiate between physiological and pathological finding. The aim of this study was to assess the structural sonographic features of joints and tendons in healthy children from several age groups (0.2–18 year), and develop a set of normative data. Methods Greyscale ultrasound was performed in 500 healthy children (age 0.2–18 years) according to a predefined scanning protocol (Additional file 1) including the shoulder, elbow, wrist, second metacarpophalangeal joint, hip, knee, ankle, and first metatarsophalangeal joint). Demographic data and values of cartilage thickness, tendon diameters, and the degree of capsular distention measured by bone-capsular distance (BCD) were collected. Differences according to the sex were assessed by unpaired t-test. Single and multiple regression analyses were performed between the ultrasound outcomes and covariates such as age, height, weight and body mass index. Growth charts and tables were developed with respect to age. Nonparametric quantile regression was applied using the R-packages quantreg and quantregGrowth. Results A total of 195 male and 305 female volunteers were included between the age of 0 and 18 years (mean age 8.9; range: 0.2–17.9 years). Cartilage diminished markedly as children aged, and cartilage of the boys was significantly thicker compared to the girls in all joints (p < 0.001). In addition, cartilage became thinner as children’s height and weight increased (beta regression coefficients between − 0.27 and − 0.01, p < 0.0001). Capsular distention (i.e., BCD > 0 mm) was uncommon in the ankle, wrist and MCP2 (resp. in 3, 6, and 3% of cases). It was more common in the suprapatellar and parapatellar knee, MTP1 and posterior recess of the elbow (resp. in 34, 32, 46, and 39% of cases). In the hip, some capsular distention was always present. Age was found to be the best predictor for BCD (beta regression coefficients between 0.05 and 0.13, p < 0.0001). Height was, in addition to age, a good predictor of tendon diameter (beta regression coefficients between 0.03 and 0.14, p < 0.0001). Growth curves and tables for each variable were developed. Conclusions Reference values of sonographic cartilage thickness, BCD and diameters of tendons at several joints were established from 500 healthy children, aged between 0.2 and 18 years. Growth charts and tables were developed to distinguish normal findings from pathology in children with complaints suspicious of arthritis.https://doi.org/10.1186/s12969-023-00895-8UltrasoundGrowth tablesNormative data |
| spellingShingle | Ruth Wittoek Céline Decock Nele Dewaele Lara Arnold Pieter Baeyens Ignace De Schrijver Lisa Pardaens Ioannis Raftakis Thomas Renson Charline Rinkin Alexander D. J. Thooft Tine Vanhaverbeke Caroline Verbist Structural ultrasound of joints and tendons in healthy children: development of normative data Pediatric Rheumatology Online Journal Ultrasound Growth tables Normative data |
| title | Structural ultrasound of joints and tendons in healthy children: development of normative data |
| title_full | Structural ultrasound of joints and tendons in healthy children: development of normative data |
| title_fullStr | Structural ultrasound of joints and tendons in healthy children: development of normative data |
| title_full_unstemmed | Structural ultrasound of joints and tendons in healthy children: development of normative data |
| title_short | Structural ultrasound of joints and tendons in healthy children: development of normative data |
| title_sort | structural ultrasound of joints and tendons in healthy children development of normative data |
| topic | Ultrasound Growth tables Normative data |
| url | https://doi.org/10.1186/s12969-023-00895-8 |
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