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Sonographic baseline physeal plate width measurements in healthy, uninjured children
Lorraine Ng1, Turandot Saul, Resa E Lewiss
1From the *Division of Pediatric Emergency Medicine, Department of Pediatrics, NYP Morgan Stanley Children's Hospital of New York; †Division of Emergency Ultrasound, Department of Emergency Medicine, Mount Sinai St. Luke's Hospital Mount Sinai Roosevelt Hospital, New York, NY; and ‡Department of Emergency Medicine, Department of Radiology, University of Colorado School of Medicine.
Insights
This study established normative physeal plate measurements in healthy children using ultrasound. Minimal variation was found between contralateral limbs, suggesting potential for early Salter-Harris injury detection.
Area of Science:
- Pediatric Radiology
- Musculoskeletal Ultrasound
- Growth Plate Imaging
Background:
- Limited data exists on normative physeal plate measurements in healthy children.
- Sonographic evaluation of physeal plates is crucial for diagnosing pediatric injuries.
Purpose of the Study:
- Determine baseline physeal plate width measurements in healthy children.
- Assess variations in physeal plate width by contralateral side, age, and sex.
Main Methods:
- Prospective observational study of 95 healthy children (0-12 years).
- Point-of-care ultrasound of distal radius, ulna, fibula, and tibia performed bilaterally.
- Measured physeal plate widths in the longitudinal plane.
Main Results:
- Mean physeal plate widths: radius (0.32cm), ulna (0.31cm), fibula (0.31cm), tibia (0.39cm).
- Mean absolute differences in contralateral physeal plate widths were minimal (e.g., radius 0.08cm).
- No significant differences in mean widths or variations were found across age groups or sexes.
Conclusions:
- Physeal plate widths show minimal statistically significant differences between contralateral extremities in healthy children.
- Established normative variance data for physeal plates in pediatric populations.
- Sonographic detection of disparities may aid early identification of Salter-Harris fractures.
Background:
There are limited data on the sonographic evaluation of normative physeal plate measurements in healthy, uninjured children.
Objectives:
This study aimed to determine baseline measurements in physeal plate widths and to assess variation in the measured widths among contralateral sides, age group, and sex in healthy, uninjured children.
Methods:
This was a prospective observational study of a convenience sample of healthy patients between 0 and 12 years of age presenting to the pediatric emergency department. A point-of-care ultrasound examination of the distal radius, ulna, fibula, and tibia was performed bilaterally (8 total). Measurements were taken at the physeal plates in the longitudinal plane at the widest distance. The degree of variance of physeal plate widths within an individual and the mean values of physeal plate widths for each bone were calculated.
Results:
A total of 95 patients were enrolled in this study. The mean age of the enrolled patients was 6 years 3 months; 40% were female. Mean (SD) physeal plate widths for the averaged measurement of each bone were as follows: radius, 0.32cm (0.09); ulna, 0.31cm (0.09); fibula, 0.31cm (0.08); and tibia, 0.39cm (0.09). Mean (SD) values for the absolute difference in physeal plate widths were as follows: radius, 0.08cm (0.06); ulna, 0.07cm (0.10); fibula, 0.06cm (0.06); and tibia, 0.06cm (0.05). When measurements were stratified by age and sex, the mean physeal plate widths and mean difference in physeal plate widths did not demonstrate any significant differences.
Conclusions:
This pilot study demonstrated that there was no statistically significant difference in physeal plate widths between contralateral extremities and the degree of variation between contralateral extremities was minimal. Results of this study elucidate normative physeal plate variance in healthy children and demonstrate that mean physeal plate measurements and absolute differences are narrow. This study suggests that sonographic detection of significant disparities in physeal plate widths of injured children may have the potential for earlier detection of Salter-Harris injuries with subsequent appropriate referral and management.
