Common Ultrasound Applications for Pediatric Musculoskeletal Conditions

Abstract

Purpose of Review To discuss the use of ultrasound for diagnosis and management of common pediatric musculoskeletal conditions through a case-based approach. Recent Findings Ultrasound is an essential diagnostic modality in the early detection of developmental dysplasia of the hips and can be used as early as 6 weeks of age when the ossific nucleus has not developed yet. Ultrasound is helpful in diagnosing traumatic injuries such as fractures and intramuscular hematomas, can visualize fracture healing at early stages, and can also be used to guide aspiration of hematomas that can help with decreasing pain and faster recovery. Ultrasound is superior to radiographs in evaluating joint effusions and soft tissue infections or masses and is better tolerated by children compared to other imaging modalities such as magnetic resonance imaging (MRI). Summary Ultrasound is an easily accessible, affordable, non-invasive, and radiation-free imaging modality that is well tolerated by children and their families. It can aid in the diagnosis and management of a wide variety of musculoskeletal conditions including developmental, traumatic, and infectious etiologies, as well as in the evaluation of superficial soft tissue masses.

Comparing Ultrasonography With Plain Radiography in the Diagnosis of Long Bone Fractures

“…19 Children are about ten times more radiosensitive compared with adults, which is the result of their smaller body size and higher mitotic activity. 20 In Germany alone, approximately 40 million extremity radiographs were performed in 2014. 21 A study revealed that 82.8% of the radiographs completed on children, for suspected fractures, provided no diagnostic evidence of a fracture.…”

Dynamic Ultrasonography for Imaging Pediatric Fat Pad Herniation through the Lateral Patellar Retinaculum

“…At the knee region in a 3-year-old child, the non-ossified patella appeared anechoic, mimicking effusion or a ganglion cyst. Furthermore, the growth plates manifest as discontinuity over the end of long bones, which can be misrecognized as fractures [ 4 ]. All of the aforementioned factors might lead to difficulty in interpreting pediatric knee ultrasound examinations.…”