title: Normal sonoanatomy of the paediatric entheses including echostructure and vascularisation changes during growth.
abstract: OBJECTIVE
  To describe the sonoanatomy of paediatric lower-limb entheses according to age and gender. We studied sites that most commonly involved entheses in spondyloarthritis.
  
  
  METHODS
  We studied 41 consecutive healthy children (20 girls, 21 boys; age 2-15 years) divided into four age groups: 2-4 years (n = 9), 5-7 years (n = 11), 8-12 years (n = 12) and 13-15 years (n = 9). Ultrasound was used to obtain both transverse and longitudinal views of each enthesis. We assessed the echostructural components of the lower limb entheses and the vascularisation of the entheses and cartilage according to the different anatomical sites and age and gender.
  
  
  RESULTS
  At all sites on B-mode, cartilage and tendon thicknesses showed positive or negative correlations with age (P < 0.0001). Side-to-side correlations were good (P < 0.0001 overall) and stronger for cartilage (r, 0.77-0.97) than for tendon thickness (r, 0.58-0.63). Agreement between the two sides for discrete data was very good to excellent (kappa, 0.77-1). Cartilage thickness at the various sites was significantly greater in boys than in girls (P ≤ 0.05). Tendon thickness was not significantly influenced by gender. Blood vessels were seen within the cartilage with differences across age groups.
  
  
  CONCLUSIONS
  This study provides the first data on normal entheseal sonoanatomy and vascularisation in children.
  
  
  CONCLUSIONS
  • 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.
authors: Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, 29609, Brest, France.
authors: Sandrine
authors: S
authors: Jousse-Joulin
authors: Claire
authors: C
authors: Cangemi
authors: Stéphanie
authors: S
authors: Gerard
authors: Simon
authors: S
authors: Gestin
authors: Luc
authors: L
authors: Bressollette
authors: Loic
authors: L
authors: de Parscau
authors: Valérie
authors: V
authors: Devauchelle-Pensec
authors: Alain
authors: A
authors: Saraux
mesh_terms: D000125:Achilles Tendon / Q000033:anatomy & histology / Q000098:blood supply / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology; D002356:Cartilage / Q000033:anatomy & histology / Q000098:blood supply / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006128:Growth / Q000502:physiology*; D006801:Humans; D008297:Male; D018919:Neovascularization, Physiologic; D017847:Patellar Ligament / Q000033:anatomy & histology / Q000098:blood supply / Q000000981:diagnostic imaging*; D000069262:Plantar Plate / Q000033:anatomy & histology / Q000098:blood supply / Q000000981:diagnostic imaging*; D012727:Sex Characteristics; D025241:Spondylarthritis / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography