Sonographic baseline physeal plate width measurements in healthy, uninjured children.

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.