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

Chambers, Greg; Kraft, Jeannette; Kingston, Kate

doi:10.1177/1742271x18759807

Cited by 6 publications

(4 citation statements)

References 75 publications

(162 reference statements)

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“…Using color Doppler, hyperemia can be visualized within and around the affected tendon. 34,35 MRI examination can be performed using T1-weighted, PD-weighted, and PD/T2weighted fat-saturated images. Apophyseal widening, irregularity, and, in severe cases, fragmentation can be seen.…”

Section: Apophysitismentioning

confidence: 99%

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Imaging of Pediatric Lower Limb Sports Injuries

Weil

Hemke

Reurink

et al. 2021

Semin Musculoskelet Radiol

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The importance of physical activity during childhood and adolescence has come to light, with an increase in sports-related acute traumatic and overuse injuries as a major disadvantage. A solid understanding of the physiology of the growing skeleton, together with knowledge about age- and sex-related differences in the occurrence of acute traumatic and overuse injuries is necessary. Every musculoskeletal radiologist should also be familiar with the appearances of these injuries on different imaging modalities. This review focuses on all these aspects concerning acute traumatic and overuse injuries among children and adolescents.

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Section: Apophysitismentioning

confidence: 99%

“…It can demonstrate hematoma at the injured site, bone irregularity, and dislocation of the apophysis, but historically it was inferior to MRI. 34,56…”

Section: Avulsion Fracturesmentioning

confidence: 99%

Imaging of Pediatric Lower Limb Sports Injuries

Weil

Hemke

Reurink

et al. 2021

Semin Musculoskelet Radiol

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“…To our knowledge, US has not been used for forensic age estimation of the knee. Based on systematic studies in healthy children and clinical experiences in traumatology and rheumatology, it is known that the bony and soft tissue structures of the knee are clearly visible and well defined in US images [60,61].…”

Section: Introductionmentioning

confidence: 99%

Forensic age assessment of the knee: proposal of a new classification system using two-dimensional ultrasound volumes and comparison to MRI

et al. 2020

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Objectives To assess epiphyseal growth plate closure of the knee for forensic age estimation using an ultrasound (US)-based method and to compare the findings with MRI. Methods Thirty-three healthy male individuals (age, 14.4–19.3 years) were prospectively evaluated for epiphyseal growth plate closure of the right knee by recordings of two-dimensional US volumes and a high-resolution T1-weighted MRI sequence. The degree of epiphyseal growth plate closure was rated independently by two readers for each method using a modality specific three-point scale that differentiates between an open physis (S1), a partially closed physis (S2), and a closed physis (S3). Results The inter-rater agreement was high for the US (Cohen’s kappa (CK): femur 95.2%, tibia 81.3%, fibula 86.3%) and the MRI method (CK: femur 70.2%, tibia 90.8%, fibula 79.8%). The degree of growth plate closure associated positively with advancing age. The US system showed a clearer separation of median ages with lower overlap than the MRI system. Open growth plates on minors (< S3 on femur and tibia) were identified by US with higher sensitivity (1.0 vs. 0.7) and slightly lower specificity (0.7 vs. 0.85) compared with MRI. The examination time was substantially shorter on US than on MRI (2.65 ± 0.91 min vs. 24.72 ± 2.72 min; p < 0.001). Conclusions The US method for evaluation of growth plate closure of the knee can reliably assign male individuals to different ossification stages and identifies minors with high accuracy. More studies with larger numbers are needed to further evaluate this method. Key Points • US is feasible to determine the degree of epiphyseal growth plate closure of the knee, shows a high degree of reliability, and is comparable to MRI. • US of the knee can detect open growth plates on male minors with high accuracy. • US of the knee may be used as a fast, non-invasive imaging tool for forensic age estimation to identify male minors.

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“…The ultrasonography (US) is a non-invasive technique that is well-tolerated by children of all ages. The high-resolution transducer depicts internal musculoskeletal structures well, which are generally sufficient in infants and young children [ 11 ]. Some case reports have introduced the utilization of US in diagnosis, treatment, and assessment of the TFDH [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus

Zhou

Zhang

et al. 2020

J Orthop Surg Res

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Background To evaluate the clinical and radiographic outcomes of ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus (TFDH). Methods Twenty-seven patients with displaced TFDH were successfully treated by the ultrasonography-guided closed reduction during January 2012 to December 2016 and were retrospectively reviewed. After the mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbows was also assessed at the latest follow-up. Results The successful rate of ultrasonography-guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 males and 7 females included in the study, and the mean age at treatment was 15.39 ± 3.10 months; seventeen fractures occurred in the right side elbow and ten in the left side. At the last follow-up, there were significant decreases in the elbow flexion (3°, P = 0.027) and range of motion (5°, P = 0.003) between the injured and uninjured elbow, respectively, whereas no difference in elbow extension was detected (P = 0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angles at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treatment was 7.4% at the last follow-up. Conclusion The ultrasonography-guided closed reduction in the treatment of displaced TFDH is an effective procedure; the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with a low incidence of postoperative cubitus varus.

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

Cited by 6 publications

References 75 publications

Imaging of Pediatric Lower Limb Sports Injuries

Imaging of Pediatric Lower Limb Sports Injuries

Forensic age assessment of the knee: proposal of a new classification system using two-dimensional ultrasound volumes and comparison to MRI

Ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus

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