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Current Pediatric Reviews

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ISSN (Print): 1573-3963
ISSN (Online): 1875-6336

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General Review Article

Non-traumatic Limping in the Child: A Pediatric Rheumatologist Perspective on Etiology, Clinical Evaluation, Laboratory Diagnosis, and Diagnostic Algorithms using Musculoskeletal Ultrasound (MSUS)

Author(s): Miroslav Harjacek*

Volume 20, Issue 3, 2024

Published on: 04 September, 2023

Page: [323 - 338] Pages: 16

DOI: 10.2174/1573396320666230801094051

Price: $65

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Abstract

Limping refers to an asymmetrical gait that deviates from the typical gait pattern expected for a child of a certain age. In most children, limping is caused by a mild, self-limiting event, such as a contusion, strain, or sprain. However, a child's limping is always a pathological finding that poses a particular diagnostic challenge and necessitates a thorough assessment. The pediatrician must weigh a wide range of acute and chronic potential causes of a non-traumatic limp, including infection, neoplasia, and chronic inflammatory disorders. A thorough history and clinical examination will help us arrive at the correct diagnosis. Understanding the typical gait is essential to recognizing and correctly interpreting the disordered one. The examination of child limping involves using a variety of diagnostic methods. Efficient and cost-effective diagnosis and treatment of the underlying condition requires a systematic approach. This review provides the pediatric rheumatologist perspective and approach for evaluating non-traumatic limp in children, with a focus on the use of point-of-care (PoC) musculoskeletal ultrasound (MSUS) as a crucial tool in daily practice.

Keywords: Child, limp, pediatric rheumatologists, gait, juvenile idiopathic arthritis, dermatomyositis, neoplasms, ultrasound.

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Graphical Abstract

[1]
Smith E, Anderson M, Foster H. The child with a limp: A symptom and not a diagnosis. Arch Dis Child Educ Pract Ed 2012; 97(5): 185-93.
[http://dx.doi.org/10.1136/archdischild-2011-301245] [PMID: 22822079]
[2]
De Inocencio J. Epidemiology of musculoskeletal pain in primary care. Arch Dis Child 2004; 89(5): 431-4.
[http://dx.doi.org/10.1136/adc.2003.028860] [PMID: 15102634]
[3]
Vos T, Allen C, Arora M, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388(10053): 1545-602.
[http://dx.doi.org/10.1016/S0140-6736(16)31678-6] [PMID: 27733282]
[4]
Herman MJ, Martinek M. The limping child. Pediatr Rev 2015; 36(5): 184-97.
[http://dx.doi.org/10.1542/pir.36.5.184] [PMID: 25934907]
[5]
Tse SML, Laxer RM. Approach to acute limb pain in childhood. Pediatr Rev 2006; 27(5): 170-80.
[http://dx.doi.org/10.1542/pir.27.5.170] [PMID: 16651274]
[6]
Dominici N, Ivanenko YP, Cappellini G, Zampagni ML, Lacquaniti F. Kinematic strategies in newly walking toddlers stepping over differ-ent support surfaces. J Neurophysiol 2010; 103(3): 1673-84.
[http://dx.doi.org/10.1152/jn.00945.2009] [PMID: 20089810]
[7]
Ivanenko YP, Dominici N, Lacquaniti F. Development of independent walking in toddlers. Exerc Sport Sci Rev 2007; 35(2): 67-73.
[http://dx.doi.org/10.1249/JES.0b013e31803eafa8] [PMID: 17417053]
[8]
Gibson ME, Stork N. Gait Disorders. Prim Care 2021; 48(3): 395-415.
[http://dx.doi.org/10.1016/j.pop.2021.04.004] [PMID: 34311847]
[9]
Beck RJ, Andriacchi TP, Kuo KN, Fermier RW, Galante JO. Changes in the gait patterns of growing children. J Bone Joint Surg Am 1981; 63(9): 1452-7.
[http://dx.doi.org/10.2106/00004623-198163090-00012] [PMID: 7320036]
[10]
Raja H, Khan SA, Waheed A. The limping child - when to worry and when to refer: A GP’s guide. Br J Gen Pract 2020; 70(698): 467.
[http://dx.doi.org/10.3399/bjgp20X712565] [PMID: 32855147]
[11]
Wassmer E, Wright E, Rideout S, Whitehouse WP. Idiopathic gait disorder among in-patients with acquired gait disorders admitted to a children’s hospital. Pediatr Rehabil 2002; 5(1): 21-8.
[http://dx.doi.org/10.1080/1363849021000007060] [PMID: 12396848]
[12]
Vezzetti R, Bordoni B. Antalgic Gait InChildren. Treasure Island: StatPearls Publishing 2022.
[13]
Lázaro Carreño MI, Fraile Currius R, García Clemente A. Non-traumatic limping in paediatric emergencies: Epidemiology, evaluation and results. Rev Esp Cir Ortop Traumatol 2018; 62(2): 127-33.
[http://dx.doi.org/10.1016/j.recot.2017.10.004]
[14]
Švehlík M, Kraus T, Steinwender G, Zwick EB, Linhart WE. Pathological gait in children with Legg-Calvé-Perthes disease and proposal for gait modification to decrease the hip joint loading. Int Orthop 2012; 36(6): 1235-41.
[http://dx.doi.org/10.1007/s00264-011-1416-2] [PMID: 22134707]
[15]
Shah AP, Indra S, Kannikeshwaran N, Hartwig E, Kamat D. Diagnostic Approach to Limp in Children Pediatr Ann 2015; 44(12): 548-56. , 552-554, 556.
[http://dx.doi.org/10.3928/00904481-20151112-01] [PMID: 26678234]
[16]
Adamson J, Waterfield T. Fifteen-minute consultation: The limping child. Arch Dis Child Educ Pract Ed 2020; 105(3): 137-41.
[http://dx.doi.org/10.1136/archdischild-2018-315905] [PMID: 31255998]
[17]
Siegel KL, Kepple TM, Stanhope SJ. A case study of gait compensations for hip muscle weakness in idiopathic inflammatory myopathy. Clin Biomech 2007; 22(3): 319-26.
[http://dx.doi.org/10.1016/j.clinbiomech.2006.11.002] [PMID: 17187908]
[18]
Achar S, Yamanaka J. Apophysitis and osteochondrosis: Common causes of pain in growing bones. Am Fam Physician 2019; 99(10): 610-8.
[PMID: 31083875]
[19]
Arnold A, Thigpen CA, Beattie PF, Kissenberth MJ, Shanley E. Overuse physeal injuries in youth athletes. Sports Health 2017; 9(2): 139-47.
[http://dx.doi.org/10.1177/1941738117690847] [PMID: 28165873]
[20]
Ladenhauf HN, Seitlinger G, Green DW. Osgood-Schlatter disease: A 2020 update of a common knee condition in children. Curr Opin Pediatr 2020; 32(1): 107-12.
[http://dx.doi.org/10.1097/MOP.0000000000000842] [PMID: 31714260]
[21]
Fares MY, Salhab HA, Khachfe HH, Fares J, Haidar R, Musharrafieh U. Sever’s disease of the pediatric population: Clinical, pathologic, and therapeutic considerations. Clin Med Res 2021; 19(3): 132-7.
[http://dx.doi.org/10.3121/cmr.2021.1639] [PMID: 34531270]
[22]
Young SW, Safran MR. Greater trochanter apophysitis in the adolescent athlete. Clin J Sport Med 2015; 25(3): e57-8.
[http://dx.doi.org/10.1097/JSM.0000000000000127] [PMID: 24942622]
[23]
Rodríguez-Olivas AO, Hernández-Zamora E, Reyes-Maldonado E. Legg-Calvé-Perthes disease overview. Orphanet J Rare Dis 2022; 17(1): 125.
[http://dx.doi.org/10.1186/s13023-022-02275-z] [PMID: 35292045]
[24]
Heesakkers N, van Kempen R, Feith R, Hendriks J, Schreurs W. The long-term prognosis of Legg-Calvé-Perthes disease: A historical pro-spective study with a median follow-up of forty one years. Int Orthop 2015; 39(5): 859-63.
[http://dx.doi.org/10.1007/s00264-014-2589-2] [PMID: 25408489]
[25]
Jandl NM, Schmidt T, Schulz M, Rüther W, Stuecker MHF. MRI and sonography in Legg-Calvé-Perthes disease: Clinical relevance of containment and influence on treatment. J Child Orthop 2018; 12(5): 472-9.
[http://dx.doi.org/10.1302/1863-2548.12.180033] [PMID: 30294371]
[26]
Li H, Zhang Z, Li C, et al. Computer-assisted design model to evaluate the outcome of combined osteotomies in Legg-Calvé-Perthes dis-ease. Front Pediatr 2022; 10: 920840.
[http://dx.doi.org/10.3389/fped.2022.920840] [PMID: 36003490]
[27]
Benenson I, Porter S. Sickle Cell Disease. Orthop Nurs 2018; 37(4): 221-7.
[http://dx.doi.org/10.1097/NOR.0000000000000464] [PMID: 30028422]
[28]
Aprato A, Conti A, Bertolo F, Massè A. Slipped capital femoral epiphysis: Current management strategies. Orthop Res Rev 2019; 11: 47-54.
[http://dx.doi.org/10.2147/ORR.S166735] [PMID: 31040725]
[29]
Abosalem AA, Sakr SAH, Mesregah MK, Zayda AI. Mid-term results of subcapital realignment of chronic slipped capital femoral epiphy-sis using surgical hip dislocation: A prospective case series. J Orthop Traumatol 2022; 23(1): 57.
[http://dx.doi.org/10.1186/s10195-022-00676-1] [PMID: 36484908]
[30]
Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LWA, Koes BW. Acute non-traumatic hip pathology in children: Inci-dence and presentation in family practice. Fam Pract 2010; 27(2): 166-70.
[http://dx.doi.org/10.1093/fampra/cmp092] [PMID: 20026553]
[31]
Taekema HC, Landham PR, Maconochie I. Towards evidence based medicine for paediatricians. Distinguishing between transient synovi-tis and septic arthritis in the limping child: How useful are clinical prediction tools? Arch Dis Child 2009; 94(2): 167-8.
[http://dx.doi.org/10.1136/adc.2008.152264] [PMID: 19158141]
[32]
Syed R. Evaluating the limping child: A rheumatology perspective. Mo Med 2016; 113(2): 131-5.
[PMID: 27311224]
[33]
Uziel Y, Butbul-Aviel Y, Barash J, et al. Recurrent transient synovitis of the hip in childhood. Longterm outcome among 39 patients. J Rheumatol 2006; 33(4): 810-1.
[PMID: 16583482]
[34]
de Borja C, Watkins R, Woolridge T. Common ultrasound applications for pediatric musculoskeletal conditions. Curr Rev Musculoskelet Med 2022; 15(6): 447-55.
[http://dx.doi.org/10.1007/s12178-022-09788-x] [PMID: 35932426]
[35]
Donders CM, Spaans AJ, van Wering H, van Bergen CJA. Developments in diagnosis and treatment of paediatric septic arthritis. World J Orthop 2022; 13(2): 122-30.
[http://dx.doi.org/10.5312/wjo.v13.i2.122] [PMID: 35317401]
[36]
Tu J, Gowdie P, Cassar J, Craig S. Test characteristics of history, examination and investigations in the evaluation for septic arthritis in the child presenting with acute non-traumatic limp. A systematic review. BMJ Open 2020; 10(12): e038088.
[http://dx.doi.org/10.1136/bmjopen-2020-038088] [PMID: 33380476]
[37]
Thomas CS, Schiffman CJ, Faino A, Bompadre V, Schmale GA. Diagnostic criteria for the painful swollen pediatric knee: Distinguishing septic arthritis from aseptic effusion in a non-lyme endemic area. Front Surg 2021; 8: 740285.
[http://dx.doi.org/10.3389/fsurg.2021.740285] [PMID: 34790694]
[38]
Nord KD, Dore DD, Deeney VF, et al. Evaluation of treatment modalities for septic arthritis with histological grading and analysis of lev-els of uronic acid, neutral protease, and interleukin-1. J Bone Joint Surg Am 1995; 77(2): 258-65.
[http://dx.doi.org/10.2106/00004623-199502000-00013] [PMID: 7844133]
[39]
Wong M, Williams N, Cooper C. Systematic review of kingella kingae musculoskeletal infection in children: Epidemiology, impact and management strategies. Pediatric Health Med Ther 2020; 11: 73-84.
[http://dx.doi.org/10.2147/PHMT.S217475]
[40]
Dong Y, Glaser K, Speer CP. New Threats from an Old Foe: Methicillin-Resistant <b><i>Staphylococcus aureus</i></b> Infections in Neonates. Neonatology 2018; 114(2): 127-34.
[http://dx.doi.org/10.1159/000488582] [PMID: 29804104]
[41]
Nickel N, Brooks S, Mize C, Messina A. Reducing Staphylococcus aureus infections in the neonatal intensive care unit. J Perinatol 2022; 42(11): 1540-5.
[http://dx.doi.org/10.1038/s41372-022-01407-4] [PMID: 35487977]
[42]
Al Farii H, Zhou S, Albers A. Management of osteomyelitis in sickle cell disease: Review article. J Am Acad Orthop Surg Glob Res Rev 2020; 4(9): e20.00002.
[http://dx.doi.org/10.5435/JAAOSGlobal-D-20-00002]
[43]
Kocher MS, Mandiga R, Zurakowski D, Barnewolt C, Kasser JR. Validation of a clinical prediction rule for the differentiation between septic arthritis and transient synovitis of the hip in children. J Bone Joint Surg Am 2004; 86(8): 1629-35.
[http://dx.doi.org/10.2106/00004623-200408000-00005] [PMID: 15292409]
[44]
Hunter S, Kennedy J, Baker JF. External validation of an algorithm to predict adjacent musculoskeletal infection in pediatric patients with septic arthritis. J Pediatr Orthop 2020; 40(10): e999-e1004.
[http://dx.doi.org/10.1097/BPO.0000000000001618] [PMID: 32740178]
[45]
Gigante A, Coppa V, Marinelli M, Giampaolini N, Falcioni D, Specchia N. Acute osteomyelitis and septic arthritis in children: A systematic review of systematic reviews. Eur Rev Med Pharmacol Sci 2019; 23(2) (Suppl.): 145-58.
[http://dx.doi.org/10.26355/eurrev_201904_17484] [PMID: 30977881]
[46]
Özkan EA, Göret CC, Özdemir ZT, et al. Pattern of primary tumors and tumor-like lesions of bone in children: Retrospective survey of biopsy results. Int J Clin Exp Pathol 2015; 8(9): 11543-8.
[PMID: 26617888]
[47]
Parmar R, Wadia F, Yassa R, Zenios M. Neuroblastoma. J Pediatr Orthop 2013; 33(4): e45-51.
[http://dx.doi.org/10.1097/BPO.0b013e318279c636] [PMID: 23653041]
[48]
Gkoudina A, Gekas C, Polydorides M, Graikos G, Papakonstantinou E, Saloupis P. Pediatric leukemia from an orthopedic perspective: A case of acute lymphoblastic leukemia initially managed as septic hip with osteomyelitis. Cureus 2022; 14(4): e24103.
[http://dx.doi.org/10.7759/cureus.24103] [PMID: 35573545]
[49]
Mongini T. Diagnostic algorithm and case conundrums: Patients presenting with proximal muscle weakness. BMC Musculoskelet Disord 2013; 14(S2) (Suppl. 2): O4.
[http://dx.doi.org/10.1186/1471-2474-14-S2-O4]
[50]
Cancarini P, Nozawa T, Whitney K, et al. The clinical features of juvenile dermatomyositis: A single-centre inception cohort. Semin Arthritis Rheum 2022; 57: 152104.
[http://dx.doi.org/10.1016/j.semarthrit.2022.152104] [PMID: 36183479]
[51]
Gorczyca D, Iwańczyk P, Staś K, Postępski J. Knee pain as a reason for referral to a paediatric rheumatologist: A retrospective study. J Paediatr Child Health 2023; 59(3): 439-44.
[http://dx.doi.org/10.1111/jpc.16309] [PMID: 36627832]
[52]
Wallny T, Brackmann HH, Seuser A, Diedrich O, Kraft CN. Haemophilic arthropathy of the hip in children - prognosis and long-term follow-up. Haemophilia 2003; 9(2): 197-201.
[http://dx.doi.org/10.1046/j.1365-2516.2003.00728.x] [PMID: 12614372]
[53]
Bakeer N, Dover S, Babyn P, et al. Musculoskeletal ultrasound in hemophilia: Results and recommendations from a global survey and consensus meeting. Res Pract Thromb Haemost 2021; 5(5): e12531.
[http://dx.doi.org/10.1002/rth2.12531] [PMID: 34268464]
[54]
Merlet AN, Chatel B, Hourdé C, et al. How sickle cell disease impairs skeletal muscle function: Implications in daily life. Med Sci Sports Exerc 2019; 51(1): 4-11.
[http://dx.doi.org/10.1249/MSS.0000000000001757] [PMID: 30095751]
[55]
Millan J, Karrs J, Helou M, Dunbar EE. The case of an adolescent male with sickle cell disease and atypical leg pain. Clin Pediatr 2020; 59(11): 1025-7.
[http://dx.doi.org/10.1177/0009922820920020] [PMID: 32456455]
[56]
Iversen PO, Hankin A, Horn J, Pedersen TH, Borgersen R, Frøen HM. Deep compartment syndrome without myonecrosis: A case report on a rare complication of sickle cell disease. Cureus 2022; 14(9): e29164.
[http://dx.doi.org/10.7759/cureus.29164] [PMID: 36258983]
[57]
Cochrane E, Young S, Shariff Z. Acute compartment syndrome in a patient with sickle cell disease. Ann R Coll Surg Engl 2020; 102(9): e1-2.
[http://dx.doi.org/10.1308/rcsann.2020.0160] [PMID: 32777927]
[58]
Weiss PF. Evaluation and treatment of enthesitis-related arthritis. Curr Med Lit Rheumatol 2013; 32(2): 33-41.
[PMID: 24403667]
[59]
Malek S, Reinhold EJ, Pearce GS. The Beighton Score as a measure of generalised joint hypermobility. Rheumatol Int 2021; 41(10): 1707-16.
[http://dx.doi.org/10.1007/s00296-021-04832-4] [PMID: 33738549]
[60]
van Leeuwen GJ, de Schepper EIT, Rathleff MS, Bindels PJE, Bierma-Zeinstra SMA, van Middelkoop M. Incidence and management of Osgood-Schlatter disease in general practice: Retrospective cohort study. Br J Gen Pract 2022; 72(717): e301-6.
[http://dx.doi.org/10.3399/BJGP.2021.0386] [PMID: 34990396]
[61]
Foster HE, Jandial S. pGALS - paediatric gait arms legs and spine: A simple examination of the musculoskeletal system. Pediatr Rheumatol Online J 2013; 11(1): 44.
[http://dx.doi.org/10.1186/1546-0096-11-44] [PMID: 24219838]
[62]
Foster H, Kay L, May C, Rapley T. Pediatric regional examination of the musculoskeletal system: A practice- and consensus-based ap-proach. Arthritis Care Res 2011; 63(11): 1503-10.
[http://dx.doi.org/10.1002/acr.20569] [PMID: 21954040]
[63]
Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol 2018; 9: 754.
[http://dx.doi.org/10.3389/fimmu.2018.00754] [PMID: 29706967]
[64]
Singhal R, Perry DC, Khan FN, et al. The use of CRP within a clinical prediction algorithm for the differentiation of septic arthritis and transient synovitis in children. J Bone Joint Surg Br 2011; 93-B(11): 1556-61.
[http://dx.doi.org/10.1302/0301-620X.93B11.26857] [PMID: 22058311]
[65]
Saltzman HM, Hobson WL, Stern SM. Interpreting rheumatology laboratory tests. Pediatr Rev 2022; 43(5): 294-6.
[http://dx.doi.org/10.1542/pir.2021-004981]
[66]
Lamot L, Miler M, Vukojević R, et al. The increased levels of fecal calprotectin in children with active enthesitis related arthritis and mri signs of sacroiliitis: The results of a single center cross-sectional exploratory study in juvenile idiopathic arthritis patients. Front Med 2021; 8: 650619.
[http://dx.doi.org/10.3389/fmed.2021.650619] [PMID: 33763437]
[67]
Jaramillo D, Dormans JP, Delgado J, Laor T, St Geme JW III. Hematogenous osteomyelitis in infants and children: Imaging of a changing disease. Radiology 2017; 283(3): 629-43.
[http://dx.doi.org/10.1148/radiol.2017151929] [PMID: 28514223]
[68]
DiPoce J, Jbara ME, Brenner AI. Pediatric osteomyelitis: A scintigraphic case-based review. Radiographics 2012; 32(3): 865-78.
[http://dx.doi.org/10.1148/rg.323115110] [PMID: 22582364]
[69]
Lee YJ, Sadigh S, Mankad K, Kapse N, Rajeswaran G. The imaging of osteomyelitis. Quant Imaging Med Surg 2016; 6(2): 184-98.
[http://dx.doi.org/10.21037/qims.2016.04.01] [PMID: 27190771]
[70]
Riquelme VS, García CB. Imaging studies in early diagnosis of childhood leukemia. Rev Chil Radiol 2012; 18(1): 24-9.
[71]
Salom M, Chiari C, Alessandri JMG, Willegger M, Windhager R, Sanpera I. Diagnosis and staging of malignant bone tumours in children: What is due and what is new? J Child Orthop 2021; 15(4): 312-21.
[http://dx.doi.org/10.1302/1863-2548.15.210107] [PMID: 34476020]
[72]
Hemke R, Kuijpers TW, Nusman CM, et al. Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis. Eur Radiol 2015; 25(11): 3222-9.
[http://dx.doi.org/10.1007/s00330-015-3752-x] [PMID: 26002127]
[73]
Malartre S, Bachasson D, Mercy G, et al. MRI and muscle imaging for idiopathic inflammatory myopathies. Brain Pathol 2021; 31(3): e12954.
[http://dx.doi.org/10.1111/bpa.12954] [PMID: 34043260]
[74]
Malattia C, Tolend M, Mazzoni M, et al. Current status of MR imaging of juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol 2020; 34(6): 101629.
[http://dx.doi.org/10.1016/j.berh.2020.101629] [PMID: 33281052]
[75]
Huang Z, Gao B, Chen H, et al. An efficacy analysis of whole-body magnetic resonance imaging in the diagnosis and follow-up of poly-myositis and dermatomyositis. PLoS One 2017; 12(7): e0181069.
[http://dx.doi.org/10.1371/journal.pone.0181069] [PMID: 28715432]
[76]
Lamot M, Lamot L, Vidovic M, Paleka Bosak E, Rados I, Harjacek M. Thermal point of care diagnostic tool for measurement of joint inflammation. Pediatric Rheumatology 2017; 15 (Suppl. 1): 53.
[77]
Lasanen R, Piippo-Savolainen E, Remes-Pakarinen T, et al. Thermal imaging in screening of joint inflammation and rheumatoid arthritis in children. Physiol Meas 2015; 36(2): 273-82.
[http://dx.doi.org/10.1088/0967-3334/36/2/273] [PMID: 25582734]
[78]
Nwaizu H, Saatchi R, Hawley DP, Ward O. Thermal and visual imaging to assist with juvenile idiopathic arthritis examination of the knees. Technologies 2020; 8(2): 30.
[http://dx.doi.org/10.3390/technologies8020030]
[79]
Balay-Dustrude E, Bhide N, Scheck J, et al. Validating within-limb calibrated algorithm using a smartphone attached infrared thermal cam-era for detection of arthritis in children. J Therm Biol 2023; 111: 103437.
[http://dx.doi.org/10.1016/j.jtherbio.2022.103437] [PMID: 36585071]
[80]
Tok F, Demirkaya E, Özçakar L. Musculoskeletal ultrasound in pediatric rheumatology. Pediatr Rheumatol Online J 2011; 9(1): 25.
[http://dx.doi.org/10.1186/1546-0096-9-25] [PMID: 21910870]
[81]
Vega-Fernandez P, Ting TV, Pratt L, Bacha CM, Oberle EJ. Ultrasonography in pediatric rheumatology. Rheum Dis Clin North Am 2022; 48(1): 217-31.
[http://dx.doi.org/10.1016/j.rdc.2021.09.009] [PMID: 34798948]
[82]
Quesada-Masachs E, Lopez-Corbeto M, Moreno-Ruzafa E. Ultrasound in pediatric rheumatology: Highlighting the differences with adults. Eur J Rheumatol 2022.
[http://dx.doi.org/10.5152/eujrheum.2022.21119] [PMID: 35943455]
[83]
Poboży T, Konarski W, Piotrowska-Lis K, Domańska J, Poboży K, Kielar M. Basic differences and most common findings in ultrasound examinations of musculoskeletal system in children: A narrative literature review. Healthcare 2022; 10(10): 2010.
[http://dx.doi.org/10.3390/healthcare10102010] [PMID: 36292459]
[84]
Gau CC, Yao TC, Gan ST, et al. Age, gender, height and weight in relation to joint cartilage thickness among school-aged children from ultrasonographic measurement. Pediatr Rheumatol Online J 2021; 19(1): 71.
[http://dx.doi.org/10.1186/s12969-021-00554-w] [PMID: 33980256]
[85]
Collado P, Vojinovic J, Nieto JC, et al. Toward standardized musculoskeletal ultrasound in pediatric rheumatology: Normal age-related ultrasound findings. Arthritis Care Res 2016; 68(3): 348-56.
[http://dx.doi.org/10.1002/acr.22670] [PMID: 26216627]
[86]
Windschall D, Collado P, Vojinovic J, et al. Age‐related vascularization and ossification of joints in children: An international pilot study to test multiobserver ultrasound reliability. Arthritis Care Res 2020; 72(4): 498-506.
[http://dx.doi.org/10.1002/acr.23335] [PMID: 28777893]
[87]
Vidovic M, Lamot L, Lamot M, Harjacek M. Intraarticular infliximab therapy in patients with juvenile idiopathic arthritis: The role of musculoskeletal ultrasound and disease activity scores in monitoring therapy response. Clin Exp Rheumatol 2018; 36(4): 676-82.
[PMID: 29600948]
[88]
Plumb J, Mallin M, Bolte RG. The role of ultrasound in the emergency department evaluation of the acutely painful pediatric hip. Pediatr Emerg Care 2015; 31(1): 54-8.
[http://dx.doi.org/10.1097/PEC.0000000000000332] [PMID: 25560622]
[89]
Zoabi M, Kvatinsky N, Shavit I. Evaluation of a point-of-care ultrasonography decision-support algorithm for the diagnosis of transient synovitis in the pediatric emergency department. JAMA Netw Open 2021; 4(7): e2116915.
[http://dx.doi.org/10.1001/jamanetworkopen.2021.16915] [PMID: 34255053]
[90]
Shahid M, Holton C, O’Riordan S, Kraft JK. Sonography of musculoskeletal infection in children. Ultrasound 2020; 28(2): 103-17.
[http://dx.doi.org/10.1177/1742271X20901736] [PMID: 32528546]
[91]
Hosokawa T, Tanami Y, Sato Y, Deguchi K, Takei H, Oguma E. Role of ultrasound in the treatment of pediatric infectious diseases: Case series and narrative review. World J Pediatr 2023; 19(1): 20-34.
[http://dx.doi.org/10.1007/s12519-022-00606-5] [PMID: 36129633]
[92]
Vidovic M, Perica M, Lamot L, Bukovac L, Harjacek M. Musculoskeletal ultrasound as complementary tool in assessing and monitoring children with reactive arthirits [REA] - Single Center Experience [AB0993 74(Suppl 2):1230.3-1231. Annials of the Rheumatic Diseases 2015; 74 (Suppl. 2): 1230-1.
[http://dx.doi.org/10.1136/annrheumdis-2015-eular.6309]
[93]
Borocco C, Anselmi F, Rossi-Semerano L. Contribution of ultrasound in current practice for managing juvenile idiopathic arthritis. J Clin Med 2022; 12(1): 91.
[http://dx.doi.org/10.3390/jcm12010091] [PMID: 36614888]
[94]
Zwir LF, Terreri MT. do Amaral e Castro A, Rodrigues WDR, Fernandes ARC. Is power Doppler ultrasound useful to evaluate temporo-mandibular joint inflammatory activity in juvenile idiopathic arthritis? Clin Rheumatol 2020; 39(4): 1237-40.
[http://dx.doi.org/10.1007/s10067-019-04731-x] [PMID: 31396836]
[95]
Demirkaya E, Özçakar L, Türker T, et al. Musculoskeletal sonography in juvenile systemic lupus erythematosus. Arthritis Rheum 2009; 61(1): 58-60.
[http://dx.doi.org/10.1002/art.24090] [PMID: 19116978]
[96]
Shenoy S, Aggarwal A. Sonologic enthesitis in children with enthesitis-related arthritis. Clin Exp Rheumatol 2016; 34(1): 143-7.
[PMID: 26812448]
[97]
Habers GEA, Van Brussel M, Bhansing KJ, et al. Quantitative muscle ultrasonography in the follow-up of juvenile dermatomyositis. Muscle Nerve 2015; 52(4): 540-6.
[http://dx.doi.org/10.1002/mus.24564] [PMID: 25557638]
[98]
Sudoł-Szopińska I, Jacques T, Gietka P, Cotten A. Imaging in dermatomyositis in adults and children. J Ultrason 2020; 20(80): e36-42.
[http://dx.doi.org/10.15557/JoU.2020.0007] [PMID: 32320164]
[99]
Song Y, Lee S, Yoo DH, Jang KS, Bae J. Strain sonoelastography of inflammatory myopathies: Comparison with clinical examination, magnetic resonance imaging and pathologic findings. Br J Radiol 2016; 89(1065): 20160283.
[http://dx.doi.org/10.1259/bjr.20160283] [PMID: 27401595]
[100]
Sridharan A, Eisenbrey JR, Forsberg F, Lorenz N, Steffgen L, Ntoulia A. Ultrasound contrast agents: Microbubbles made simple for the pediatric radiologist. Pediatr Radiol 2021; 51(12): 2117-27.
[http://dx.doi.org/10.1007/s00247-021-05080-1] [PMID: 34117892]

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