Skip to main content
SpringerLink
Log in

Pediatric Musculoskeletal Disorders

  • Chapter
  • First Online:
Musculoskeletal Ultrasonography in Rheumatic Diseases

  • 1683 Accesses

Abstract

Musculoskeletal ultrasound (US) is an innocuous and bedside method for evaluating children. US is routinely being used by increased number of rheumatologists and pediatric rheumatologists in their clinical practice. The steady advance in US investigation in the pediatric rheumatology field has endorsed its usefulness in inflammatory diseases and infectious diseases (e.g., osteomyelitis). This chapter evaluates the spectrum of joint diseases in children concentrating on the aspects that are unique to the immature skeleton.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Magni-Manzoni S, Collado P, Jousse-Joulin S, Naredo E, D’Agostino MA Muratore V, Merli P, Roth J, (on behalf of the) Paediatric ultrasound group of the OMERACT Ultrasound Task Force Current state of musculoskeletal ultrasound in paediatric rheumatology: results of an international survey. Rheumatology 2014;53:491–6.

    Article  PubMed  Google Scholar 

  2. Buchmann RF, Jaramillo D. Imaging of articular disorders in children. Radiol Clin North Am. 2004;42:151–68.

    Article  PubMed  Google Scholar 

  3. Azouz EM. Juvenile idiopathic arthritis: how can the radiologist help the clinician? Pediatr Radiol. 2008;38(Suppl 3):S403–8.

    Article  PubMed  Google Scholar 

  4. Collado P, Naredo E. Ecografía osteoarticular en reumatología pediátrica. Ann Pediatr Contin. 2007a;5:366–8.

    Article  Google Scholar 

  5. Collado P, Naredo E, Calvo C, Gamir ML, Calvo I, García ML, Merino R, Graña J, Bustabab S, Garrido J; ECO-JIA Study Group. Reduced joint assessment vs comprehensive assessment for ultrasound detection of synovitis in juvenile idiopathic arthritis. Rheumatology. 2013;52:1477–84.

    Article  PubMed  Google Scholar 

  6. Graf R. Fundamentals of sonographic diagnosis of infant hip dysplasia. J Pediatr Orthop. 1984;4:735–40.

    Article  CAS  PubMed  Google Scholar 

  7. Magni-Manzoni S, Scirè CA, Ravelli A, Klersy C, Rossi S, Muratore V, Visconti C, Lanni S, Merli P, Montecucco C. Ultrasound-detected synovial abnormalities are frequent in clinically inactive juvenile idiopathic arthritis, but do not predict a flare of synovitis. Ann Rheum Dis. 2013;72:223–8.

    Article  PubMed  Google Scholar 

  8. Magni-Manzoni S, Epis O, Ravelli A, Klersy C, Veisconti C, Lanni S, Muratore V, Sciré CA, Rossi S, Montecucco C. Comparison of clinical versus ultrasound-determined synovitis in juvenile idiopathic arthritis. Arthritis Rheum. 2009;61:1497–504.

    Article  PubMed  Google Scholar 

  9. Haslam KE, McCann LJ, Wyatt S, Wakefield RJ. The detection of subclinical synovitis by ultrasound in oligoarticular juvenile idiopathic arthritis: a pilot study. Rheumatology. 2010;49:123–7.

    Article  PubMed  Google Scholar 

  10. Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, Maldonado-Cocco J, Orozco-Alcala J, Prieur AM, Suarez-Almazor ME, Woo P. International league of associations for rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton 2001. J Rheumatol. 2004;31:390–2.

    PubMed  Google Scholar 

  11. Müller L, Kellenberger CJ, Cannizzaro E, Ettlin D, Schraner T, Bolt IB, Peltomäki T, Saurenmann RK. Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology. 2009;48:680–5.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Melchiorre D, Falcini F, Kaloudi O, Bandinelli F, Nacci F, Matucci Cerinic M. Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis. J Ultrasound. 2010;13:34–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Assaf AT, Kahl-Nieke B, Feddersen J, Habermann C. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis? Dentomaxillofac Radiol. 2013;42(3):20110379.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Collado P, Jousse-Joulin S, Alcalde M, Naredo E, D’Agostino MA. Is ultrasound a validated imaging tool for the diagnosis and management of synovitis in juvenile idiopathic arthritis? a systematic literature review. Arthritis Care Res. 2012;64:1011–9.

    Google Scholar 

  15. Bearcroft PW, Berman LH, Robinson AH, Butler GJ. Vascularity of the neonatal femoral head: in vivo demonstration with power Doppler US. Radiology. 1996;200:209–11.

    Article  CAS  PubMed  Google Scholar 

  16. Naredo E, Wakefield RJ, Iagnocco A, Terslev L, Filippucci E, Gandjbakhch F, Aegerter P, Aydin S, Backhaus M, Balint PV, Bruyn GA, Collado P, Finzel S, Freeston JE, Gutierrez M, Joshua F, Jousse-Joulin S, Kane D, Keen HI, Moller I, Mandl P, Ohrndorf S, Pineda C, Schmidt WA, Szkudlarek M, Conaghan PG, D’Agostino MA. The OMERACT ultrasound task force-status and perspectives. J Rheumatol. 2011;38:2063–7.

    Article  PubMed  Google Scholar 

  17. Collado P, Naredo E. Sonographic image of children’s joints. Badalona: EUROMEDICE, Ediciones Médicas; 2007b.

    Google Scholar 

  18. Khanna PC, Thapa MM. The growing skeleton: MR imaging appearances of developing cartilage. Radiol Clin Am. 2009;47:899–909.

    Article  Google Scholar 

  19. Wallace CA, Ruperto N, Giannini E. Preliminary criteria for cinical remission for select categories of juvenile idiopathic arthritis. J Rheumatol. 2004;31:2290–4.

    PubMed  Google Scholar 

  20. Guzman J, Burgos-Vargas R, Duarte-Salazar C, Gomez-Mora P. Reliability of the articular examination in children with juvenile rheumatoid arthritis: interobserver agreement and sources of disagreement. J Rheumatol. 1995;22:2331–6.

    CAS  PubMed  Google Scholar 

  21. Goff I, Rowan A, Bateman BJ, Foster HE. Poor sensitivity of musculoskeletal history in children. Arch Dis Child. 2012;97:644–6.

    Article  PubMed  Google Scholar 

  22. Filippou G, Cantarini L, Bertoldi I, Picerno V, Frediani B, Galeazzi M. Ultrasonography vs clinical examination in children with suspected arthritis. Does it make sense to use poliarticular ultrasonographic screening? Clin Exp Rheumatol. 2011;29: 345–50.

    CAS  PubMed  Google Scholar 

  23. Breton S, Jousse-Joulin S, Cangemi C, de Parscau L, Colin D, Bressolette L, Saraux A, Devauchelle-Pensec V. Comparison of clinical and ultrasonographic evaluations for peripheral synovitis in juvenile idiopathic arthritis. Semin Arthritis Rheum. 2011;41:272–8.

    Article  PubMed  Google Scholar 

  24. Jousse-Joulin S, Breton S, Cangemi C, Fenoll B, Bressolette L, de Parscau L, Saraux A, Devauchelle-Pensec V. Ultrasonography for detecting enthesitis in juvenile idiopathic arthritis. Arthritis Care Res. 2011;63:849–55.

    Article  Google Scholar 

  25. Janow GL, Panghaal V, Trinh A, Badger D, Levin T, Ilowite N. Detection of active disease in juvenile idiopathic arthritis: sensitivity and specificity of the physical examination vs ultrasound. J Rheumatol. 2011;38:2671–4.

    Article  PubMed  Google Scholar 

  26. Wakefield RJ, Balint PV, Szkudlarek M. on behalf of the OMERACT Special Interest Group. The OMERACT 7 Special Interest Group: diagnosed musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol. 2005;32:2485–7.

    PubMed  Google Scholar 

  27. Frosch M, Foell D, Ganser G, Roth J. Arthrosonography of hip and knees joints in the follow up of juvenile rheumatoid arthritis. Ann Rheum Dis. 2003;62:242–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Collado P, Naredo E, Calvo C, Crespo M. Assessment of the joint recesses and tendon sheaths in healthy children by high-resolution B-mode and power Doppler sonography. Clin Exp Rheumatol. 2007;25:915–21.

    CAS  PubMed  Google Scholar 

  29. Lamer S, Sebag G. MRI and ultrasound in children with juvenile chronic arthritis. Eur J Radiol. 2000;33:85–93.

    Article  CAS  PubMed  Google Scholar 

  30. El-Miedany YM, Housny IH, Mansour HM, Mourad HG, Mehanna AM, Megeed MA. Ultrasound versus MRI in the evaluation of juvenile idiopathic arthritis of the knee. Joint Bone Spine. 2001;68:222–30.

    Article  CAS  PubMed  Google Scholar 

  31. Doria AS, Kiss MHB, Lotito AP, Molnar LJ, de Castro CC, Medeiros CC, Cerri GG. Juvenile rheumatoid arthritis of the knee: evaluation with contrast-enhanced color Doppler ultrasound. Pediatr Radiol. 2001;31:524–31.

    Article  CAS  PubMed  Google Scholar 

  32. Rooney M, Mcallister C, Burns JF. Ankle disease in juvenile idiopathic arthritis: ultrasound findings in clinically swollen ankles. J Rheumatol. 2009;36:1725–9.

    Article  PubMed  Google Scholar 

  33. Pascoli L, Wright S, Mcallister C, Rooney M. Prospective evaluation of clinical and ultrasound findings in ankle disease in juvenile idiopathic arthritis: importance of ankle ultrasound. J Rheumatol. 2010;37:2409–14.

    Article  PubMed  Google Scholar 

  34. Laurell L, Court-Payen M, Nielsen S, Zak M, Boesen M, Fasth A. Ultrasonography and color Doppler in juvenile idiopathic arthritis: diagnosis and follow-up of ultrasound- guided steroid injection in the ankle region. A descriptive interventional study. Pediatr Rheumatol Online J. 2011;9:4.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Laurell L, Court-Payen M, Nielsen S, Zak M, Fasth A. Ultrasonography and color Doppler in juvenile idiopathic arthritis: diagnosis and follow-up of ultrasound-guided steroid injection in the wrist region. A descriptive interventional study. Pediatr Rheumatol Online J. 2012;10:11.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Fisher C, Ioannou Y, Hall-Craggs M, Sen D. Enthesitis related arthritis; a new era of understanding. Ann Paediatr Rheum. 2012;1:8–16.

    Article  Google Scholar 

  37. Grechenig W, Mayr J, Peicha G, Hammerl R, Schatz B, Grechenig S. Sonoanatomy of the Achilles tendon insertion in children. J Clin Ultrasound. 2004;32:338–43.

    Article  PubMed  Google Scholar 

  38. Malattia C, Damasio MB, Magnaguagno F, Pistorio A, Valle M, Martinoli C, Viola S, Buoncompagni A, Loy A, Ravelli A, Tomà P, Martini A. Magnetic resonance imaging, ultrasonography, and conventional radiography in the assessment of bone erosions in juvenile idiopathic arthritis. Arthritis Rheum. 2008;59:1764–7.

    Article  PubMed  Google Scholar 

  39. Pradsgaard DØ, Spannow AH, Heuck C, Herlin T. Decreased cartilage thickness in juvenile idiopathic arthritis assessed by ultrasonography. J Reumatol. 2013;40:1596–603.

    Google Scholar 

  40. Karmazyn B, Bowyer SL, Schidt KM, Ballinger SH Buckwalter K, Beam T. US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis, Pediatr Radiol. 2007;37:475–82.

    Article  PubMed  Google Scholar 

  41. Daldrup-Link HE, Steinbach L. MR imaging of pediatric arthritis. Magn Reson Imaging Clin N Am. 2009;17:451–67.

    Article  PubMed  Google Scholar 

  42. Zawin JA, Hoffer FA, R and FF, Teele RL. Joint effusion in children with an irritable hip: US diagnosis and aspiration. Radiology. 1993;187:459–63.

    Article  CAS  PubMed  Google Scholar 

  43. Zukotynski K, Jarrin J, Babyn S, Carcao M, Pazmino-Canizares J, Stain AM, Doria AS. Ultrasonography of joints and correlation with function in hemophilic arthropathy in children and young adults: interim results of a German clinical pilot trial. Haemophilia. 2007;13:293–304.

    Article  CAS  PubMed  Google Scholar 

  44. Rebollo-Polo M, Koujok K, Weisser C, Jurencak R, Bruns A, Roth J. Ultrasound findings on patients with juvenile idiopathic arthritis in clinical remission. Arthritis Care Res. 2011;63:1013–9.

    Article  Google Scholar 

  45. Collado P, Gamir ML, López-Robledillo JC, Merino R, Modesto C, Monteagudo I. Detection of synovitis by ultrasonography in clinically inactive juvenile idiopathic arthritis on and off medication. Clin Exp Rheumatol. 2014;32:597–603.

    PubMed  Google Scholar 

  46. Jaramillo D, Treves SD, Kasser JR, Harper M, Sundel R, Laor T. Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol 1995;165:399–403.

    Article  CAS  PubMed  Google Scholar 

  47. Chau CLF, Griffith JF. Musculoskeletal infections: ultrasound appearances. Clin Radiol. 2005;60:149–59.

    Article  CAS  PubMed  Google Scholar 

  48. Strouse PJ, DiPietro MA, Adler RS. Pediatric hip effusions: evaluation with power Doppler sonography. Radiology. 1998;206:731–5.

    Article  CAS  PubMed  Google Scholar 

  49. Gordon JE, Huang M, Dobbs M, Luhmann SJ, Szymanski DA, Schoenecker PL. Causes of false-negative ultrasound scans in the diagnosis of septic arthritis of the hip in children. J Pediatr Orthop. 2002;22:312–6.

    PubMed  Google Scholar 

  50. Crow A, Cheung A, Lam A, Ho E. Sonography for the investigation of a child with a limp. AJUM. 2010;13:23–30.

    Google Scholar 

  51. Do TT. Transient synovitis as a cause of painful limps in children. Curr Opin Pediatr. 2000;12:48–51.

    Article  CAS  PubMed  Google Scholar 

  52. Luhmann SJ, Jones A, Schootman M, Gordon JE, Schoenecker PL, Luhmann JD. Differentiation between septic arthritis and transient synovitis of the hip in children with clinical prediction algorithms. J Bone Joint Surg Am. 2004;86:956–62.

    PubMed  Google Scholar 

  53. Vlychou M, Athanasou NA. Radiological and pathological diagnosis of paediatric bone tumours and tumour-like lesions. Pathology. 2008;40:196–216.

    Article  CAS  PubMed  Google Scholar 

  54. Robben SG, Lequin MH, Diepstraten AF, den Hollander JC, Entius CA, Meradji M. Anterior joint capsule of the normal hip and in children with transient synovitis: US study with anatomic and histologic correlation. Radiology. 1999;210:499–507.

    Article  CAS  PubMed  Google Scholar 

  55. Liberman B, Herman A, Schindler A, Sherr-Lurie N, Ganel A, Givon U. The value of hip aspiration in pediatric transient synovitis. J Pediatr Orthop. 2013;33:124–7.

    Article  PubMed  Google Scholar 

  56. Aksoy MC, Aksoy DY, Haznedaroglu IC, Sayinalp N, Kirazli S, Alpaslan M. Thrombomodulin and GFC levels in Legg-Calve-Perthes disease. Hematology. 2008;13:324–8.

    Article  CAS  PubMed  Google Scholar 

  57. Doria AS, Cunha FG, Modena M, Maciel R, Molnar LJ, Luzo C, Moineddin R, Guarniero R. Legg-Calvé-Perthes disease: multipositional power Doppler sonography of the proximal femoral vascularity. Pediatr Radiol. 2008;38:392–402.

    Article  PubMed  Google Scholar 

  58. Bhargava S, Bhargava SK. Infective arthritis of hip: role of sonography. JIMSA. 2013;26:15–6.

    Google Scholar 

  59. Dimeglio A, Canavese F. Imaging in Legg-Calvé-Perthes disease. Orthop Clin North Am. 2011;42:297–302.

    Article  PubMed  Google Scholar 

  60. Murray AW, Wilson NIL. Changing incidence of slipped capital femoral epiphysis a relationship with obesity? J Bone Joint Surg Br. 2008;90-B(1):92–4.

    Article  Google Scholar 

  61. Kallio PE, Lequesne GW, Paterson DC, Foster BK. Ultrasonography in slipped capital femoral epiphysis. Diagnosis and assessment of severity. J Bone Joint Surg Br. 1991;73:884–9.

    CAS  PubMed  Google Scholar 

  62. Terjesen T. Ultrasonography for diagnosis of slipped capital femoral epiphysis. Comparison with radiography in 9 cases. Acta Orthop Scand. 1992;63:653–7.

    CAS  PubMed  Google Scholar 

  63. Magnano GM, Lucigrai G, De Filippi C, et al. Diagnostic imaging of the early slipped capital femoral epiphysis. Radiol Med. 1998;95:16–20.

    CAS  PubMed  Google Scholar 

  64. McCabe A. Is ultrasound or plain film radiography a more sensitive diagnostic modality for diagnosing slipped capital femoral epiphysis? Emerg Med J. 2014;31:80.

    Article  Google Scholar 

  65. Castriota-Scanderbeg A, Orsi E. Slipped capital femoral epiphysis: ultrasonographic findings. Skeletal Radiol. 1993;22:191–3.

    Article  CAS  PubMed  Google Scholar 

  66. Kallio PE, Paterson DC, Foster BK, Lequesne GW. Classification in slipped capital femoral epiphysis. Sonographic assessment of stability and remodeling. Clin Orthop Relat Res. 1993;294:196–203.

    PubMed  Google Scholar 

  67. Jaramillo D, Villegas-Medina O, Doty D, Rivas R, Strife K, Dwek JR. Age-related vascular changes in epiphysis, physis and metaphysis: normal findings on gadolinium-enhanced MRI of piglets. AJR. 2004;182:353–60.

    Article  PubMed  Google Scholar 

  68. Riise OR, Kirkhus E, Handeland KS, Flato B, Reiseter T, Cvancarova M, Nakstad B, Wathne KO. Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study. BMC Pediatr. 2008;8:45.

    Article  PubMed Central  PubMed  Google Scholar 

  69. Sreenivas T, Nataraj AR, Menon J, Patro DK. Acute multifocal haematogenous osteomyelitis in children. J Child Orthop. 2011;5:231–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  70. Van Schuppen J, van Doorn MAC, van Rijn RR. Childhood osteomyelitis: imaging characteristics. Insights Imaging. 2012;3:519–33.

    Article  PubMed Central  PubMed  Google Scholar 

  71. Riebel E, Nash R, Nazarenko O. The value of sonography in the detection of osteomyelitis. Pediatric Radiol. 1996;26:291–7.

    Article  CAS  Google Scholar 

  72. Zamzam MM. The role of ultrasound in differentiating septic arthritis from transient synovitis of the hip in children. J Pediatr Orthop B. 2006;15:418–22.

    Article  PubMed  Google Scholar 

  73. Collado P, Naredo E, Calvo C, Crespo M. The role of power Doppler sonography in the early diagnosis of osteomyelitis in children. J Clin Ultrasound. 2008;36:251–3.

    Article  PubMed  Google Scholar 

  74. Tlougan BE, Podjasek JO, O’Haver J, Cordova KB, Nguyen XH, Tee R, Pinckard-Hansen KC, Hansen RC. Chronic recurrent multifocal osteomyelitis (CRMO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with associated neutrophilic dermatoses: a report of seven cases and review of the literature. Pediatr Dermatol. 2009;26:497–505.

    Article  PubMed  Google Scholar 

  75. Blankstein A, Cohen I, Heim M, Diamant L, Salai M, Chechick A, Ganel A. Ultrasonography as diagnostic modality in Osgood-Schlatter disease. A clinical study and review of the literature. Arch Orthop Trauma Surg. 2001;121:536–9.

    Article  CAS  PubMed  Google Scholar 

  76. Carr JC, Hanly S, Griffin J, Gibney R. Sonography of the patellar tendon and adjacent structures in pediatric and adult patients. AJR. 2001;176:1535–9.

    Article  CAS  PubMed  Google Scholar 

  77. Pisacano RM, Miller TT. Comparing sonography with MR imaging of apophyseal injuries of the pelvis in four boys. AJR. 2003;181:223–30.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rheumatology, Paediatric Rheumatology Unit, Hospital Universitario Severo Ochoa, Avenida De Orellana S/N, 28911, Madrid, Spain

    Assoc. Prof. Paz Collado Ramos MD, PhD & Eva Álvarez Andrés MD

Authors
  1. Assoc. Prof. Paz Collado Ramos MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eva Álvarez Andrés MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paz Collado Ramos MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Rheumatology, Darent Valley Hospital, Dartford, United Kingdom

    Yasser El Miedany

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Collado Ramos, P., Álvarez Andrés, E. (2015). Pediatric Musculoskeletal Disorders. In: El Miedany, Y. (eds) Musculoskeletal Ultrasonography in Rheumatic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-15723-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-15723-8_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15722-1

  • Online ISBN: 978-3-319-15723-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation