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Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Sonographic evaluation of the endochondral ossification process of the thyroid cartilage in children
Adalet Elcin Yildiz1, Seda Kaynak Sahap2, Atilla Halil Elhan3
1Department of Radiology, Ankara Children's Hematology Oncology Training Hospital, Ankara, Turkey.
Insights
Ultrasound imaging reveals that endochondral ossification of the thyroid cartilage in children begins in the first decade. These hypoechoic foci are common and can appear expansile, requiring radiologist awareness to prevent misdiagnosis.
Area of Science:
- Pediatric radiology
- Anatomy and physiology
- Medical imaging
Background:
- The endochondral ossification process of the thyroid cartilage is not well-defined in pediatric populations.
- Understanding these changes is crucial for accurate interpretation of imaging studies.
Purpose of the Study:
- To characterize the sonographic features of thyroid cartilage endochondral ossification in children.
- To establish normative data for this developmental process.
Main Methods:
- Sonography (US) of the thyroid cartilage was performed on 420 children using a high-resolution linear-array transducer.
- The right and left laminae, including inferior horns, were examined for ossification foci, noting their presence, location, shape, size, echo pattern, and number.
Main Results:
- Ossification foci were detected in 39.9% of 419 children (mean age 109.8 months).
- The earliest detection age was 72 months for girls and 79 months for boys.
- Hypoechoic, nonexpansile foci were the most common appearance, increasing in prevalence and number with age.
Conclusions:
- Endochondral ossification of the thyroid cartilage initiates in the first decade, presenting as hypoechoic foci on ultrasound.
- Radiologists must recognize these common, potentially expansile findings to avoid misinterpreting them as pathological masses.
Purpose:
To determine the sonographic appearances of the endochondral ossification process of the thyroid cartilage in children.
Methods:
Thyroid cartilage sonography (US) of 420 children was performed with a high-resolution linear-array transducer. Right and left laminae of the thyroid cartilage, including the inferior horns, were examined. Ossification foci were evaluated for their presence, location, shape, size, echo pattern, and number.
Results:
Four hundred nineteen children, 239 girls and 180 boys, were enrolled in the study with a mean age of 109.8 ± 60.7 months. Ossification foci were found in 167 children (39.9%). First ossification focus detection age was 72 months in girls and 79 months in boys. On both laminae, the most frequent appearance of the ossification focus was hypoechoic (right: 94.8%, left: 93.5%). Prevalence and number of ossification foci increased with age in each sex. The shape of the ossification foci in both laminae was generally nonexpansile (right: 92.9%, left: 93.5%).
Conclusion:
Endochondral ossification process of the thyroid cartilage begins in the first decade with extracellular matrix changes, which can be detected as hypoechoic foci by US. These foci can be expansile, and radiologists should be aware of this entity to avoid misdiagnosing them as abnormal masses.
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