Collado P, Naredo E, Calvo C, Crespo M
Department of Rheumatology, Unit of Pediatric Rheumatology, Hospital Severo Ochoa, Madrid, Spain.
Clin Exp Rheumatol. 2007 Nov-Dec;25(6):915-21.
To describe or determine reference values for the intracapsular cavity and its joint recess of the hip, knee and joints of the hand and for the tendon sheaths of fingers, examined with B-mode gray-scale ultrasonography (US) and power Doppler (PD) in healthy children.
Sixty healthy children (31 boys and 29 girls; age range 2-16 years) were examined bilaterally with gray-scale and PD US (after obtaining the informed consent), using a standardized technique. The maximum distance from bone surface to the outer margin of the capsule (namely, intracapsular cavity) and its joint recess of hip, knee, wrist, non-thumb metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the hand were measured with US. Mean values +/- 2 SD (standard deviation) were indicated as reference values.
None of the children showed joint hip fluid. In 5% of the children younger than 5 years an intra-capsular PD flow signal was detected in the posterior layer of the hip capsule. Fluid was detected in 60 % of the suprapatellar recesses. A small amount of fluid was detected within synovial recesses of the fingers, most commonly in the 2 MCP and PIP joints. Less frequently, a hypoechoic rim was detected around the finger flexor tendons on the palmar surface of the metacarpal bone.
High-resolution US evidences a normal small amount of fluid located at the MCP and IFP joint recesses and/or the flexor tendon sheaths without any PD flow signal in healthy children, that is relevant for interpreting ultrasonographic findings in children with inflammatory diseases.
描述或确定健康儿童髋、膝、手部关节的关节囊内腔及其关节隐窝以及手指腱鞘的参考值，采用B型灰阶超声（US）和能量多普勒（PD）进行检查。
60名健康儿童（31名男孩和29名女孩；年龄范围2 - 16岁）在获得知情同意后，采用标准化技术进行双侧灰阶和PD US检查。用超声测量髋、膝、腕、手部非拇指掌指关节（MCP）和近端指间关节（PIP）从骨表面到关节囊外缘（即关节囊内腔）及其关节隐窝的最大距离。均值±2标准差（标准差）被指定为参考值。
所有儿童均未显示髋关节积液。5%的5岁以下儿童在髋关节囊后层检测到囊内PD血流信号。60%的髌上隐窝检测到积液。在手指滑膜隐窝内检测到少量积液，最常见于2个MCP和PIP关节。较少见的是，在掌骨掌面的指屈肌腱周围检测到低回声边缘。
高分辨率超声显示健康儿童MCP和IFP关节隐窝和/或屈肌腱鞘内有少量正常积液且无任何PD血流信号，这对于解释炎症性疾病患儿的超声检查结果具有重要意义。
