Common Ultrasound Applications for Pediatric Musculoskeletal Conditions

Overview

Journal Curr Rev Musculoskelet Med

Date 2022 Aug 6

PMID 35932426

Authors

Celina de Borja

Rhonda Watkins

Tiana Woolridge

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: To discuss the use of ultrasound for diagnosis and management of common pediatric musculoskeletal conditions through a case-based approach.

Recent Findings: Ultrasound is an essential diagnostic modality in the early detection of developmental dysplasia of the hips and can be used as early as 6 weeks of age when the ossific nucleus has not developed yet. Ultrasound is helpful in diagnosing traumatic injuries such as fractures and intramuscular hematomas, can visualize fracture healing at early stages, and can also be used to guide aspiration of hematomas that can help with decreasing pain and faster recovery. Ultrasound is superior to radiographs in evaluating joint effusions and soft tissue infections or masses and is better tolerated by children compared to other imaging modalities such as magnetic resonance imaging (MRI). Ultrasound is an easily accessible, affordable, non-invasive, and radiation-free imaging modality that is well tolerated by children and their families. It can aid in the diagnosis and management of a wide variety of musculoskeletal conditions including developmental, traumatic, and infectious etiologies, as well as in the evaluation of superficial soft tissue masses.

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References

Shah S, Callahan M . Ultrasound evaluation of superficial lumps and bumps of the extremities in children: a 5-year retrospective review. Pediatr Radiol. 2013; 43 Suppl 1:S23-40. DOI: 10.1007/s00247-012-2590-0. View

Kim H, Yoo S, Oh S, Jeon T, Kim J . Ultrasonography of Pediatric Superficial Soft Tissue Tumors and Tumor-Like Lesions. Korean J Radiol. 2020; 21(3):341-355. PMC: 7039727. DOI: 10.3348/kjr.2019.0343. View

Nelson C, Chen A, Bellah R, Biko D, Ho-Fung V, Francavilla M . Ultrasound features of purulent skin and soft tissue infection without abscess. Emerg Radiol. 2018; 25(5):505-511. DOI: 10.1007/s10140-018-1612-0. View

Lin M, Neuman M, Rempell R, Monuteaux M, Levy J . Point-of-Care Ultrasound is Associated With Decreased Length of Stay in Children Presenting to the Emergency Department With Soft Tissue Infection. J Emerg Med. 2017; 54(1):96-101. DOI: 10.1016/j.jemermed.2017.09.017. View

Takundwa P, Chen L, Malik R . Evaluation of Hip Pain and Management of Toxic Synovitis in the Ultrasound Era. Pediatr Emerg Care. 2021; 37(1):34-38. DOI: 10.1097/PEC.0000000000002314. View

Ackermann O, Simanowski J, Eckert K . Fracture Ultrasound of the Extremities. Ultraschall Med. 2020; 41(1):12-28. DOI: 10.1055/a-1023-1782. View

Shahid M, Holton C, ORiordan S, Kraft J . Sonography of musculoskeletal infection in children. Ultrasound. 2020; 28(2):103-117. PMC: 7254949. DOI: 10.1177/1742271X20901736. View

Jejurikar N, Moscona-Mishy L, Rubio M, Cavallaro R, Castaneda P . What is the Interobserver Reliability of an Ultrasound-enhanced Physical Examination of the Hip in Infants? A Prospective Study on the Ease of Acquiring Skills to Diagnose Hip Dysplasia. Clin Orthop Relat Res. 2021; 479(9):1889-1896. PMC: 8373553. DOI: 10.1097/CORR.0000000000001863. View

Taylor I, Burlile J, Schaeffer E, Geng X, Habib E, Mulpuri K . Developmental Dysplasia of the Hip: An Examination of Care Practices of Pediatric Orthopaedic Surgeons in North America. J Pediatr Orthop. 2020; 40(4):e248-e255. DOI: 10.1097/BPO.0000000000001505. View

10.

Rodriguez Bandera A, Sebaratnam D, Feito Rodriguez M, de Lucas Laguna R . Cutaneous ultrasound and its utility in pediatric dermatology. Part I: Lumps, bumps, and inflammatory conditions. Pediatr Dermatol. 2019; 37(1):29-39. DOI: 10.1111/pde.14033. View

11.

Dubrovsky A, Kempinska A, Bank I, Mok E . Accuracy of ultrasonography for determining successful realignment of pediatric forearm fractures. Ann Emerg Med. 2014; 65(3):260-5. DOI: 10.1016/j.annemergmed.2014.08.043. View

12.

Hryhorczuk A, Restrepo R, Lee E . Pediatric Musculoskeletal Ultrasound: Practical Imaging Approach. AJR Am J Roentgenol. 2016; 206(5):W62-72. DOI: 10.2214/AJR.15.15858. View

13.

Ryan D . Differentiating Transient Synovitis of the Hip from More Urgent Conditions. Pediatr Ann. 2016; 45(6):e209-13. DOI: 10.3928/00904481-20160427-01. View

14.

Bansal A, Rosenberg H . Sonography of pediatric superficial lumps and bumps: illustrative examples from head to toe. Pediatr Radiol. 2017; 47(9):1171-1183. DOI: 10.1007/s00247-017-3859-0. View

15.

Cross K, Warkentine F, Kim I, Gracely E, Paul R . Bedside ultrasound diagnosis of clavicle fractures in the pediatric emergency department. Acad Emerg Med. 2010; 17(7):687-93. DOI: 10.1111/j.1553-2712.2010.00788.x. View

16.

Lussier E, Sun Y, Chen H, Chang T, Chang C . Ultrasound screening for developmental dysplasia of the hip after 4 weeks increases exam accuracy and decreases follow-up visits. Pediatr Neonatol. 2018; 60(3):270-277. DOI: 10.1016/j.pedneo.2018.07.008. View

17.

Plumb J, Mallin M, Bolte R . The role of ultrasound in the emergency department evaluation of the acutely painful pediatric hip. Pediatr Emerg Care. 2015; 31(1):54-8. DOI: 10.1097/PEC.0000000000000332. View

18.

Zhang A, Falkowski A, Jacobson J, Kim S, Koh S, Gaetke-Udager K . Sonography of Wrist Ganglion Cysts: Which Location Is Most Common?. J Ultrasound Med. 2018; 38(8):2155-2160. DOI: 10.1002/jum.14912. View

19.

Lam S, Sivitz A, Alade K, Doniger S, Tessaro M, Rabiner J . Comparison of Ultrasound Guidance vs. Clinical Assessment Alone for Management of Pediatric Skin and Soft Tissue Infections. J Emerg Med. 2018; 55(5):693-701. PMC: 6369916. DOI: 10.1016/j.jemermed.2018.07.010. View

20.

Barbic D, Chenkin J, Cho D, Jelic T, Scheuermeyer F . In patients presenting to the emergency department with skin and soft tissue infections what is the diagnostic accuracy of point-of-care ultrasonography for the diagnosis of abscess compared to the current standard of care? A systematic review and.... BMJ Open. 2017; 7(1):e013688. PMC: 5253602. DOI: 10.1136/bmjopen-2016-013688. View