Normal sonoanatomy of the paediatric entheses including echostructure and vascularisation changes during growth

Jousse‐Joulin, Sandrine; Cangémi, C.; Gerard, S.; Gestin, Simon; Bressollette, L; Parscau, L. De; Devauchelle‐Pensec, Valérie; Saraux, Alain

doi:10.1007/s00330-014-3586-y

Cited by 21 publications

(22 citation statements)

References 20 publications

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“…NSAID use was associated with an increased risk of synovial effusion and increased synovial effusion/hypertrophy quantitative score. In previous reports of knee tendon features on MSUS in healthy children, no vascularity was detected in the patellar tendons [25,26]. Patellar tendon hyperemia is a significantly different finding in our case participants compared to control groups, which suggests that the tendon may be associated with pathology in hypermobile joints.…”

Section: Discussioncontrasting

confidence: 70%

Musculoskeletal ultrasound assessment in pediatric knee hypermobility: a case control study

2021

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Background While musculoskeletal ultrasound (MSUS) use in pediatric rheumatology is becoming more common, the majority of pediatric MSUS literature continues to focus on ultrasound findings in healthy children and juvenile idiopathic arthritis with little discussion of other musculoskeletal problems that may mimic arthritis such as joint hypermobility. Chronic joint pain related to hypermobility is a common referral to pediatric rheumatology clinics. Our aim is to describe the musculoskeletal ultrasound (MSUS) characteristics of the knee in a population with joint hypermobility and pain in comparison to control participants. Methods Participants were recruited into three groups for a case-control study. Case group participants had knee hypermobility and pain symptoms (H + P). Participants in one control group had knee hypermobility without pain symptoms (H-P), and participants in the other control group had no knee hypermobility or pain symptoms (NP). B-mode and Doppler MSUS images were obtained and scored for each knee. Descriptive statistics are used for demographic variables and MSUS findings. Regression analysis is used to evaluate risk of synovial effusion and higher synovial effusion/hypertrophy quantitative score. Results MSUS assessment was performed on 91 knees of 50 participants. H + P knees were more likely to have positive findings noted on MSUS (94% vs. 70% of H-P and 74% of NP knees, p = 0.043). Patellar tendon hyperemia was more common in H + P knees (52%, vs. 19% among H-P and 23% among NP, p = 0.025). Participants who reported taking scheduled non-steroidal anti-inflammatory drugs (NSAIDs) had an increased risk of synovial effusion (RR = 1.83, 95% CI = 1.07–2.30, p = 0.026) and a trend towards increased risk of a higher synovial effusion/hypertrophy quantitative score (RR = 1.77, 95% CI = 0.92–3.38, p = 0.086). Conclusions While positive MSUS findings were frequent in all participants, patellar tendon hyperemia was more frequent in participants with knee hypermobility and pain symptoms. Additionally, reported use of NSAIDs was associated with an increased risk of synovial effusion and higher synovial effusion/hypertrophy quantitative score. Further study should assess correlation between tendon abnormalities and degree of pain symptoms as well as the effect of NSAIDs on MSUS findings.

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Section: Discussioncontrasting

confidence: 70%

Musculoskeletal ultrasound assessment in pediatric knee hypermobility: a case control study

2021

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“…Furthermore it remains normal US enthesis in children to be defined. Jousse-Joulin et al found that tendon thickness at enthesis insertion in children varied significantly with age, but was not influenced by gender [25].Also, the aspect of the bone-cartilage interface varied according to whether the ossification centre had deve loped within the cartilage: wavy in younger patients, then rounded and, finally, hyperechoic at puberty [25]. Important to say is that enthesalgia may be present in up to 1/3 of healthy school-age children [20,26].…”

Section: Us Appearance Of Musculoskeletal Structures In Healthy Childrenmentioning

confidence: 99%

What’s new in musculoskeletal ultrasound in pediatric rheumatology?

Spârchez

Fodor

2018

Med Ultrason

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Musculoskeletal ultrasound (MSUS) has become almost indispensable in the rheumatology settings nowadays, allowing early diagnosis, careful guidance during procedures such as joint injections and therapy monitoring. Nonetheless, the applicability of MSUS in pediatric population is still limited. Recently, a standardized MSUS examination procedure in pediatric patients with rheumatic diseases, definitions for synovitis and the sonographic features of joints in healthy children has been developed. Also, important data on age-related vascularization and ossification of joints in children have been published. Much work still needs to be done in the field. As juvenile idiopathic arthritis seems to be the most common use of MSUS in pediatric rheumatology, specific definitions and assessment techniques for enthesitis, tenosynovitis, bone and cartilage damage in children are very much expected. In this article, we will review briefly the current evidence-based knowledge regarding MSUS potential applications in the pediatric rheumatology clinical practice, along with an overview of the recent information about US appearance of musculoskeletal structures in healthy children.

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“…Sonographic appearances of normal joints and entheses in healthy children and changes that occur with age are documented in recent articles. 12,13 Apophyseal avulsion injuries Acute apophyseal injury often occurs during sporting activity when a sudden forceful muscular contraction applies violent traction tension to the tendon attachment at the apophysis. The apophysis can partially or completely detach from the underlying bone, occasionally with complete functional loss of the attaching muscle.…”

Section: Normal Paediatric Skeletal Anatomymentioning

confidence: 99%

“…Sonographic appearances of normal joints and entheses in healthy children and changes that occur with age are documented in recent articles. 12,13…”

Section: Normal Paediatric Skeletal Anatomymentioning

confidence: 99%

The role of ultrasound as a problem-solving tool in the assessment of paediatric musculoskeletal injuries

2018

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Musculoskeletal trauma in the paediatric population covers a wide range of injuries; although many overlap with their adult counterparts, others are exclusive to the immature skeletal system. Ultrasound is a versatile tool particularly suited to both the imaging of children and the dynamic assessment of musculoskeletal injuries. This pictorial review aims to discuss a range of injuries, focusing on those commonly encountered in children. We shall describe the muscle-tendon-bone complex and changes that occur with increasing skeletal maturity and how this affects the type of injury encountered.

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Normal sonoanatomy of the paediatric entheses including echostructure and vascularisation changes during growth

Abstract: • The tendons of children exhibit the same fibrillar structure as adults • Tendon thickness at enthesis insertion in children is not influenced by gender • Cartilage thickness in children decreases with advancing age and varies with gender.

Cited by 21 publications

References 20 publications

Musculoskeletal ultrasound assessment in pediatric knee hypermobility: a case control study

Musculoskeletal ultrasound assessment in pediatric knee hypermobility: a case control study

What’s new in musculoskeletal ultrasound in pediatric rheumatology?

The role of ultrasound as a problem-solving tool in the assessment of paediatric musculoskeletal injuries

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