Objective To compare the diagnostic efficacy of musculoskeletal ultrasound and X-ray in adolescents with Os-good-Schlatter disease and analyze the ultrasonographic findings of such patients.Methods Ninety-nine adolescent patients who sought medical attention due to pain at the tibial tuberosity of the knee from January 2020 to December 2022 were included.A senior orthopedic surgeon confirmed the diagnosis based on clinical diagnostic criteria,musculoskeletal ultrasound images and X-ray images.The diagnostic efficacy of musculoskeletal ultrasoundand X-ray was compared in terms of missed diagnosis rate,misdiagnosis rate,sensitivity,specificity,accuracy,positive predictive value and negative predictive value.Re-sults Among the 99 cases,78 were confirmed to have Osgood-Schlatter disease,while 21 cases were not(including 6 cases of subcutaneous soft tissue contusion at the tibial tuberosity,6 cases of patellar tendon injury,4 cases of subcutaneous effusion,2 cases of infrapatellar bursa effusion,2 cases of soft tissue hematoma,and 1 case of tibial tuberosity fracture).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of musculoskeletal ultrasound were higher than those of X-ray,but with lower missed diagnosis rate and misdiagnosis rate.The differences were statistically significant(P＜0.05).Patients with Osgood-Schlatter disease presented with one or more of the following ultrasonographic findings:swelling of the anterior cartilage of tibial tuberosity,characterized by increased thickness of the cartilage with low echogenicity;swelling of subcutaneous softtissues,characterized by thickened and uneven echogenic subcutaneous tissues;swelling at the lower insertion of the patellar tendon,characterized by the thickening of distal patellar tendon with reduced echogenicity in the longitudinal sec-tion;fragmentation of the secondary ossification center of tibial tuberosity,characterized by discontinuity in the ossification cen-ter with multiple strong echoes;effusion in the infrapatellar bursa,characterized by a fluid sonolucent area on the medial side beneath the patellar tendon;color Doppler ultrasound revealed that blood flow signals were detected at the patellar tendon at-tachment and at the cartilage of tibial tuberosity.Conclusion Musculoskeletal ultrasound has a higher diagnostic efficacy than X-ray in adolescents with Osgood-Schlatter disease.The integration of musculoskeletal ultrasound and color Doppler ultra-sound enables the detection of distinct specific signs,providing a more precise evaluation of pathological changes.
万方数据
维普
