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Ultrasound assessment of glenohumeral dysplasia in infants
Sarah J Menashe1, Anh-Vu Ngo2, Marisa B Osorio3
1Department of Radiology, Seattle Children's Hospital and University of Washington School of Medicine, 4800 Sandpoint Way NE, MA.7.220, Seattle, WA, 98105, USA. sarah.menashe@seattlechildrens.org.
Insights
Brachial plexus birth injuries can cause upper extremity deformities. Ultrasound (US) offers a cost-effective, dynamic imaging tool for early diagnosis and monitoring of glenohumeral joint pathology in affected infants.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Neurology
Background:
- Brachial plexus birth injury (BPBI) can cause permanent upper extremity neuromuscular dysfunction and skeletal deformities, including glenohumeral dysplasia.
- Effective management of BPBI necessitates a multidisciplinary approach, with medical imaging playing a crucial role in diagnosis and monitoring.
- Magnetic Resonance Imaging (MRI) provides comprehensive assessment but is limited by cost and sedation requirements, typically reserving it for preoperative planning.
Purpose of the Study:
- To review the utility of ultrasound (US) in the diagnosis and follow-up of brachial plexus birth injuries.
- To describe the relevant anatomy of the glenohumeral joint and its sonographic appearance in neonates.
- To provide practical guidance for identifying and characterizing glenohumeral joint pathology using US.
Main Methods:
- Review of existing literature and clinical experience regarding the use of ultrasound for brachial plexus birth injuries.
- Description of normal glenohumeral joint anatomy and sonographic findings in infants.
- Guidance on sonographic techniques for evaluating pathology associated with BPBI.
Main Results:
- Ultrasound is an accessible, inexpensive, and dynamic imaging modality suitable for early diagnosis and follow-up of BPBI.
- US provides excellent visualization of the predominantly cartilaginous glenohumeral joint in infants.
- Specific sonographic features aid in the identification and characterization of pathologies resulting from BPBI.
Conclusions:
- Ultrasound is a valuable tool for the early diagnosis and ongoing management of brachial plexus birth injuries.
- Its dynamic capabilities and cost-effectiveness make it ideal for routine assessment of the glenohumeral joint in affected infants.
- This review offers a practical guide for clinicians utilizing US in the evaluation of BPBI.
Abstract:
Brachial plexus birth injury can lead to irreversible neuromuscular dysfunction and skeletal deformity of the upper extremity and shoulder girdle, ultimately resulting in glenohumeral dysplasia. Diagnosis and treatment of affected infants requires a multi-disciplinary approach in which imaging plays a vital role. While MRI is excellent for assessing both the shoulder and spine of these children, it is costly and requires sedation and is thus typically reserved for preoperative planning. US, however, is inexpensive, dynamic and readily available and provides excellent visualization of the largely cartilaginous glenohumeral joint. As such, it has become a highly useful modality during early diagnosis and follow-up of children with brachial plexus birth injuries. In this review, we describe the relevant anatomy of the glenohumeral joint, outlining the normal sonographic appearance as well as providing tips and tricks for identifying and characterizing pathology.
