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Imaging
Original article
Normative ultrasound references for the paediatric wrist; dorsal soft tissues
  1. Karen Rosendahl1,2,
  2. Ingvild Sævold Bruserud3,
  3. Ninnie Oehme3,
  4. Pétur Benedikt Júlíusson3,4,
  5. Laura Tanturri de Horatio5,
  6. Lil-Sofie Ording Müller6 and
  7. Silvia Magni-Manzoni7
  1. 1Department of Radiology, Haukeland University Hospital, Bergen, Norway
  2. 2Department of Clinical Medicine, K1, University of Bergen, Bergen, Norway
  3. 3Department of Clinical Medicine, K2, University of Bergen, Bergen, Norway
  4. 4Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
  5. 5Department of Radiology, Bambino Gesù Children’s Hospital, Rome, Italy
  6. 6Department of Radiology and Intervention, Oslo University Hospital, Oslo, Norway
  7. 7Pediatric Rheumatology, Bambino Gesù Children’s Hospital, Rome, Italy
  1. Correspondence to Dr Karen Rosendahl; karen.rosendahl{at}helse-bergen.no

Abstract

Objective To report novel ultrasound (US) references for the healthy paediatric wrist.

Methods Healthy children and adolescents had an US examination including Doppler, of the right wrist, using a mid-sagittal image through the radiocarpal (RC)/midcarpal (MC) joints. These features were noted: appearances and depth of the recess, with an additional measurement in the flexed position and number of Doppler signals within the recess in close proximity to the joint. In a second, blinded session, all images were reassessed by the same observer.

Results In total, 116 subjects (59 girls) aged 6–16 years (mean 10 years and 11 months) were included. The RC recess was visible in 71, of which 60 were non-bulging and 11 were bulging. In flexion, the thickness decreased in 60 (84.5%), suggestive of joint fluid. Of the 54 visible MC recesses, 45 (83.3%) thinned in flexion. The mean depths of the RC and MC recesses were 0.4 mm (SD 0.5, range 0–2.9) and 0.5 mm (SD 0.6, range 0–2.4), respectively, with no differences according to sex, but with increasing depths by age.

For the RC joints, at least one Doppler signal was seen in the recess in 9/116 joints (7.8%), whereas this was true for 3.5% of the MC recesses. There were no statistically significant association between the depth of the RC or MC recesses and number of hand active sport activities (P=0.733 and P=0.091, respectively).

Conclusion The appearances of the dorsal RC and MC recesses in healthy children may mimic pathology. Hence, findings should be interpreted carefully.

  • ultrasonography
  • juvenile idiopathic arthritis
  • synovial fluid

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/rmdopen-2017-000642

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    Footnotes

    • Contributors All authors contributed to the planning, reporting, discussion and final approval of the article. KR performed all the ultrasound examinations and drafted the first version of the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The Regional Ethics Committee (REK), HelseVest, Bergen, Norway.

    • Provenance and peer review Not commissioned; externally peer reviewed.