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U. Zaleska-Dorobisz ; Wroclaw/PL, Olesnica/PL
Keywords: Pediatric, Musculoskeletal joint, Anatomy, Ultrasound,
Elastography, Ultrasound-Power Doppler, Education, Education
and training, Trauma
DOI: 10.1594/ecr2015/C-2434
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Learning objectives
Background
1: anterior compartment (patella, suprapatellar recess, patellar ligament and it's insertion,
quadriceps tendon, cartilage structure)
Normal images differ among age groups. It is important to be familiar with ultrasound
characteristics od ossification centers.
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Fig. 5: 5-month-old child. Longitudinal view of anterior knee compartment. Note the
ossification center in distal femur and hypoechoic cartilage.
References: Department of Radiology . Wroclaw University Hospital
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Fig. 2: Longitudial view. Patellar ligament. Normal ultrasound anatomy in 7-year-old
child.
References: Department of Radiology . Wroclaw University Hospital
Page 4 of 13
References: Department of Radiology . Wroclaw University Hospital
Fig. 3: Longitudial view. Medial aspect of knee joint . Normal ultrasound anatomy in 7-
year-old child.
References: Department of Radiology . Wroclaw University Hospital
Page 5 of 13
Fig. 4: Ultrasonografic findings - fracture. Discontinuity of periosteum is visible.
Adjacent soft tissues are hypoechoic - hemartoma. Increased vascularity of this area in
PowerDoppler.
References: Department of Radiology . Wroclaw University Hospital
Osgood Schlatter disease typically occurs in patients between 9 and 16 years old . Male
to female ratio - 3:1.
Location : ligament-bone junction of the patellar ligament and the tibial tuberosity.
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Fig. 6: Osgood Schlatter disease - typical ultrasound findings . Arrows show
fragmentation of the apophysis (tibial tuberosity) and cartilage swelling (green arrows).
References: Department of Radiology . Wroclaw University Hospital
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Fig. 1: Longitudial view. Suprapatellar recess. Normal ultrasound anatomy in 7-year-old
child.
Fig. 2: Longitudial view. Patellar ligament. Normal ultrasound anatomy in 7-year-old child.
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Fig. 3: Longitudial view. Medial aspect of knee joint . Normal ultrasound anatomy in 7-
year-old child.
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Fig. 4: Ultrasonografic findings - fracture. Discontinuity of periosteum is visible.
Adjacent soft tissues are hypoechoic - hemartoma. Increased vascularity of this area in
PowerDoppler.
Page 10 of 13
Fig. 5: 5-month-old child. Longitudinal view of anterior knee compartment. Note the
ossification center in distal femur and hypoechoic cartilage.
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Fig. 7: Sinding Larsen Johansen disease. Arrow shows fragmentation od of lowerpole of
the patella. Cartilage swelling is also visible. Stars - tendinosis of patellar ligemnt.
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Conclusion
Knowledge of anatomy landmarks is essential for scanning the knee accurately and
efficiently. In pediatric patients also the appearance of bony parts differs depending on
age: occification centers, articular cartilage, epiphysis.
Easy to follow ultrasound examination protocol can be a useful tool in everyday practice
of pediatric radiologists.
Personal information
References
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