Dias Sílvia Costa, Carvalho Diogo Costa, Castro Miguel, Dias Cláudia Camila, Ramos Isabel, Brito Iva, Rosendahl Karen
Faculty of Medicine of the University of Porto, Rua Pedro Hispano nº 190, 2º Dto, Porto, 4100-393, Portugal.
Radiology Department, University Hospital Center of São João Porto, Porto, Portugal.
Pediatr Radiol. 2025 May 2. doi: 10.1007/s00247-025-06243-0.
With increasing ultrasound use, data for the normal amount of joint fluid and synovial appearances are needed.
To establish reference values for knee-ultrasound in healthy volunteers by age. To examine the association of joint fluid and synovial appearances with age, sex, and time spent in sports activities.
Prospective, cross-sectional, including 3-17-year-old volunteers. Examinations were performed by one of two experienced radiologists after meticulous standardisation of the technique. Knees were examined in 30° flexion, in extension and during provocation.
One hundred twenty-seven volunteers (67 females), median age 10.9 years (percentile 2.5-97.5: 3.4-17.2), were included. With 30° knee flexion, the median amount of suprapatellar recess joint fluid (sagittal view) was 0.5 mm for females and 0.9 mm for males (P = 0.014), increasing to 1.9 mm and 2.4 mm (P = 0.031), respectively, during provocation. The amount of fluid during provocation increased with age for both sexes (P = 0.007 females; P = 0.012 males) and by time spent in sport-activities (P = 0.003). Further, there was a positive association between the presence of joint fluid speckles and sport-activities (P = 0.039). Median double-layered synovium was 1.5 mm in 3-6-year-olds, increasing to 2.1 mm in 7-9-year-olds and 2.0 mm in 10-17-year-olds (P = 0.024). No synovial Doppler signal was seen. Observers' agreement was excellent, with ICC values ≥ 0.9.
The majority of healthy children have measurable knee joint fluid, more so when examined with a flexed knee and under provocation. Speckles within the joint fluid are seen in one-fourth, especially in males, and the presence of speckles and joint fluid amount are associated with sports-activity.
随着超声检查的使用日益增多，需要有关关节液正常量和滑膜表现的数据。
按年龄为健康志愿者建立膝关节超声的参考值。研究关节液和滑膜表现与年龄、性别及体育活动时间的关联。
前瞻性横断面研究，纳入3至17岁的志愿者。由两名经验丰富的放射科医生之一在对技术进行细致标准化后进行检查。在膝关节屈曲30°、伸直位及激发试验时对膝关节进行检查。
纳入127名志愿者（67名女性），中位年龄10.9岁（第2.5至97.5百分位数：3.4至17.2岁）。膝关节屈曲30°时，女性髌上隐窝关节液（矢状面）中位值为0.5毫米，男性为0.9毫米（P = 0.014），激发试验时分别增至1.9毫米和2.4毫米（P = 0.031）。激发试验时的关节液量在男女两性中均随年龄增加（女性P = 0.007；男性P = 0.012），且随体育活动时间增加（P = 0.003）。此外，关节液斑点的出现与体育活动呈正相关（P = 0.039）。3至6岁儿童双层滑膜中位值为1.5毫米，7至9岁增至2.1毫米，10至17岁为2.0毫米（P = 0.024）。未观察到滑膜多普勒信号。观察者间一致性良好，组内相关系数（ICC）值≥0.9。
大多数健康儿童膝关节有可测量的关节液，屈膝检查及激发试验时更明显。四分之一的儿童关节液内可见斑点，男性尤为明显，斑点的出现及关节液量与体育活动相关。
