Ultraschall Med 2016; 37 - SL3_4
DOI: 10.1055/s-0036-1587726

Paediatric musculoskeletal ultrasound – Examination of the joint capsule shape in healthy children and adolescents

R Trauzeddel 1, D Windschall 2, H Lehmann 3, C Nirschl 2, G Ganser 4, K Palm-Beden 4, R Berendes 5, M Haller 6, M Krumrey-Langkammerer 7, P Schoof 8, A Nimtz-Talake 9, RF Trauzeddel 10
  • 1Helios Hospital Berlin-Buch, Department of Pediatric and Adolescent Medicine, Berlin, Germany
  • 2Asklepios Hospital Weissenfels, Department of Pediatrics, Weissenfels, Germany
  • 3University Medicine Gießen, Department of Pediatrics, Gießen, Germany
  • 4North-Western German Centre for Rheumatology, Department of Pediatric and Adolescent Rheumatology, Sendenhorst, Germany
  • 5Sankt Marien Children"s Hospital, Department of Pediatrics, Landshut, Germany
  • 6Pediatrics and Adolescent Practice, Gundelfingen, Germany
  • 7German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
  • 8Pediatric Practice, Munich, Germany
  • 9Pediatric Practice, Frankfurt/Oder, Germany
  • 10Charité University Medicine, Anesthesiology and Intensive Care Medicine, Berlin, Germany

Purpose: In rheumatic diseases a convex shape of the joint capsule is valid as a sign of joint effusion. Up to now there are no studies about the capsule shape in a healthy childhood population.

Material and methods: In an age- and sex-related multicentre study, we examined the formation of the capsules of shoulder, elbow, hip and ankle joints. The evaluation was performed in a longitudinal scan in healthy children and adolescents between 2 and 18 years of age. The shape of the capsule was classified into concave, straight or convex in relation to the bone surface located dorsally of the capsule.

Results: We evaluated 447 study participants, 245 of them being girls. They were classified into six age groups, which constituted three-year age ranges. For the shoulder and ankle joints, we found a predominantly concave form in all age groups. Regarding the elbow joint, particularly the younger age groups showed both a concave and a straight capsule formation with a concavity increasing with age. In external rotation, the hip joint capsule showed a predominantly concave or straight form, whereas the capsule had a rather convex or straight shape in the neutral position of the joint.

Conclusion: A convex joint capsule shape can also be found in healthy children and adolescents. It, therefore, cannot be interpreted separately as a sonographic sign for a joint effusion or a synovia inflammation.