title: Pediatric musculoskeletal ultrasound: age- and sex-related normal B-mode findings of the knee.
abstract: Musculoskeletal ultrasound (MSUS) is an important tool for evaluating disease activity, therapeutic progress, and remission status of rheumatic diseases in children. Knowledge of age-related normal findings is essential when interpreting pathological findings such as those seen in juvenile idiopathic arthritis. To evaluate normal findings of the knee joint, we recorded age-related stages of musculoskeletal development in the knee of 435 healthy children between 1 and 18 years of age using high-resolution B-mode MSUS. We determined approximate age- and sex-related norms for the suprapatellar recess size, ossified patella size, and distal femoral intercondylar cartilage thickness. In almost all age-groups, over 64 % of children had visible fluid accumulation in the suprapatellar recess. Significant correlations were found between chronological age and the suprapatellar recess size and ossified patella length (p < 0.05). An age-dependent decrease in intercondylar cartilage thickness of the distal femoral epiphysis was found in children between 10 and 18 years of age. High-resolution B-mode MSUS is an excellent tool for assessing joint and skeletal development in children. Our reference data can be used to discriminate better between normal physiological findings and pathological abnormalities.
authors.affiliation: Department of Pediatrics, Asklepios Hospital Weissenfels, Naumburger-Strasse 76, 06667, Weissenfels, Germany. d.windschall@asklepios.com.
authors.forename: Daniel
authors.identifier: http://orcid.org/0000-0003-3156-5103
authors.initials: D
authors.lastname: Windschall
authors.affiliation: Department of Pediatric Rheumatology, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Trauzeddel
authors.affiliation: Practice for Pediatrics and Pediatric Rheumatology, Alte Bundesstrasse 37, 79194, Gundelfingen, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Haller
authors.affiliation: German Center for Pediatric Rheumatology, Gehfeldstrasse 24, 82467, Garmisch-Partenkirchen, Germany.
authors.forename: Manuela
authors.initials: M
authors.lastname: Krumrey-Langkammerer
authors.affiliation: Practice for Pediatrics and Pediatric Rheumatology, Am Kleistpark 1, 15230, Frankfurt (Oder), Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Nimtz-Talaska
authors.affiliation: Department of Pediatric Rheumatology, St. Marien Children's Hospital, Grillparzerstrasse 9, 84036, Landshut, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Berendes
authors.affiliation: Clinic for Pediatric Rheumatology, St. Josef Stift, Westtor 7, 48324, Sendenhorst, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Ganser
authors.affiliation: Department of Pediatrics, Asklepios Hospital Weissenfels, Naumburger-Strasse 76, 06667, Weissenfels, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Nirschl
authors.affiliation: Practice for Pediatrics and Pediatric Rheumatology, Cosimastrasse 133, 81925, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Schoof
authors.affiliation: Charité University Medicine, 10117, Berlin, Germany.
authors.forename: Ralf Felix
authors.initials: RF
authors.lastname: Trauzeddel
authors.affiliation: Clinic for Pediatric Rheumatology, St. Josef Stift, Westtor 7, 48324, Sendenhorst, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Palm-Beden
authors.affiliation: Department for Pediatric Rheumatology, Clinic for Pediatrics and Neonatology, Justus Liebig-University Giessen, Feulgenstrasse 10-12, 35392, Giessen, Germany.
authors.forename: Hartwig
authors.initials: H
authors.lastname: Lehmann
mesh_terms: D000293:Adolescent; D002061:Bursa, Synovial / Q000000981:diagnostic imaging*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007717:Knee / Q000000981:diagnostic imaging*; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D010329:Patella / Q000000981:diagnostic imaging*; D012016:Reference Values; D014463:Ultrasonography / Q000379:methods*
keywords: Cartilage thickness; Knee; Musculoskeletal ultrasound; Ossification; Patella size; Suprapatellar recess