Normal hip joint fluid volumes in healthy children of different ages, based on MRI volumetric quantitative measurement
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ORIGINAL ARTICLE
Normal hip joint fluid volumes in healthy children of different ages, based on MRI volumetric quantitative measurement Vanessa Quinn-Laurin 1 & Bashiar Thejeel 1 & Nancy A. Chauvin 2 & Timothy G. Brandon 3 & Pamela F. Weiss 3,4,5 & Jacob L. Jaremko 1 Received: 7 February 2020 / Revised: 29 April 2020 / Accepted: 24 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background While magnetic resonance imaging (MRI) of the pelvis and hips is common in pediatric patients, to date there are no data on the quantification of normal hip joint fluid volume in this patient population. Objective We sought to assess the feasibility and reliability of quantitative hip joint fluid measurement in the pediatric population to estimate the normal volume of fluid in a pediatric hip joint. Materials and methods Seventy healthy children ages 8–17 years underwent a pelvic MRI including a large field of view coronal T2 fat-saturated sequence where hips were entirely imaged. Following 3 training sessions, 2 readers with experience in musculoskeletal imaging performed volumetric quantitative measurements of hip fluid (140 hips) using semiautomated pixel-based thresholding on custom MATLAB software. Results The mean processing time per hip was 2 min, 41 s. The mean volume of fluid in a hip joint was 2.1 mL (range: 0.38– 5.41 mL), increasing slightly with age. Volumes were also greater in boys than in girls (P=0.004). Intra-observer and interobserver agreement were high (intra-class correlation coefficients 0.93 and 0.98, respectively), with mean volume differences of 0.04 mL for intra-observer and 0.09 mL for interobserver. Conclusion A semiautomated pixel-based thresholding approach was feasible and reliable for measuring joint fluid in pediatric hip MRI. The average fluid volume of 2.1 mL can represent a visually substantial quantity of fluid per MRI slice, particularly in small children, and should not be misinterpreted as a joint effusion. Keywords Children . Hip . Joint fluid . Magnetic resonance imaging . Normal . Physiological
* Jacob L. Jaremko [email protected] 1
Department of Radiology, University of Alberta Hospital and Stollery Children’s Hospital, 2J2.00 WC Mackenzie Health Sciences Centre, 8440 112 St. NW, Edmonton, Alberta T6G 2R7, Canada
2
Department of Radiology, Hershey Children’s Hospital and Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Philadelphia, PA, USA
3
Department of Pediatrics, Division of Rheumatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
4
Department of Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
5
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Introduction Distinguishing between normal physiological quantities of joint fluid and pathological joint effusion is difficult. The first-line imaging test for a hip effusion in a child is ultrasound (US), but it only assesses the quantity of fl
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