Paediatric musculoskeletal US beyond the hip joint

Abstract

US is a technique particularly suited to the investigation of musculoskeletal disorders in children and adolescents. This review paper describes a range of clinical settings beyond the hip joint where US has a significant role to play, including sports injuries, infectious diseases, inflammatory and degenerative conditions, congenital and developmental disorders, acute trauma of bone and joints, and peripheral nerve injuries. In some circumstances, US can be regarded as the most effective means of diagnostic imaging, whereas in other instances, it is an alternative or supplement to other more comprehensive imaging modalities, like MRI and CT. Although MRI offers superior soft-tissue contrast resolution, US is low-cost, non-invasive and has higher spatial resolution and real-time capability for the assessment of musculoskeletal structures during joint movement and stress manoeuvres.Keywords Ultrasound . Musculoskeletal system . Trauma . Child High-resolution US is particularly well suited to examine the paediatric musculoskeletal system. An exquisite depiction of the immature skeleton and soft tissues can be obtained in a well-tolerated and non-invasive way without using ionising radiation or sedation. Although US has been widely used in the diagnosis of hip disorders in children, many other applications for US of the paediatric musculoskeletal system have been developed [1,2]. Over other imaging techniques, US is ideally suited for the evaluation of tendons, muscles, joints, ligaments and nerves. In addition, it may provide specific information on bone and cartilage. In this article, we review the use of US in a variety of musculoskeletal applications beyond the hip, including sports injuries, infectious diseases, inflammatory and degenerative conditions, congenital and developmental disorders, acute trauma of bone and joints, and peripheral nerve injuries. Sports-related injuries Apophyseal injuriesIn children and adolescents, apophyseal injuries are commonly related to sporting and recreational activities. Especially in the age range between 12 and 16 years, the ossification centres of most apophyses are still immature and the cartilage, under hormonal influence, loses elasticity and is unable to give firm stability to the osteotendinous junction. Hence, the rough shear or torsion forces exercised upon them by tendons and ligaments can overcome the threshold of cartilage and bone resistance causing fragmenDisclaimer The supplement this article is part of is not sponsored by the industry. Dr.

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