Obez çocuklarda distal femoral kartilajın us-elastografi ile değerlendirilmesi
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Tarih
2023
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Obezite rahatsızlığı olan çocuklarda eklem kartilaj değişikliklerinin tespitinde US ve Elastografinin tanıdaki öneminin araştırılması ve ek dejeneratif hastalıkların teşhisinde kullanılabilecek bazal verilerin elde edilmesini sağlamaktır. Materyal ve Metot: Çalışmaya Kırıkkale Üniversitesi Tıp Fakültesi etik kurul onayı ile başlanmıştır. Prospektif kesitsel bir çalışma olarak planlanmıştır. Çalışmaya 75 normal ve 75 obez (toplam 150) çocuk dahil edilmiş olup her çocukta bilateral distal femoral kartilaj değerlendirilmiştir. B mod ultrasonografi incelemesi ile her iki distal femoral kartilajda suprapatellar ve infrapatellar yöntemle kalınlık ölçümü ve dejenerasyon bulguları değerlendirildi. Shear wave elastografi ve strain elastografi ile kartilaj elastisitesine yönelik kalitatif ve kantitatif değerlendirme yapıldı. İstatistiksel analizler yapılırken SPSS 21.0 paket programı kullanılmıştır. Bulgular: Yaş ortalamaları kontrol grubu 12,68, hasta grubu 13,12 idi. Vücud-Kitle İndensi(VKİ)'nin sağ ve sol infrapatellar kartilaj kalınlıkları üzerinde istatistiksel olarak anlamlı bir etkiye sahip olmadığı saptanmış (p>0,05) iken, Yaş ve cinsiyetin sağ ve sol infrapatellar kartilaj kalınlığı üzerinde istatistiksel olarak anlamlı bir etkiye sahip olduğu saptanmıştır (p<0,05). Cinsiyete göre distal femoral kartilaj kalınlıkları arasında tespit edilen fark istatistiksel olarak anlamlı saptanmıştır (p<0,05). VKİ'nin suprapatellar yöntemle ölçülen sol distal femoral kartilaj kalınlığı üzerinde istatistiksel olarak anlamlı bir etkiye sahip olmadığı saptanmış iken (p>0,05), yaş ve cinsiyet sağ ve sol suprapatellar yöntemle ölçülen kartilaj kalınlığı üzerinde istatistiksel olarak anlamlı bir etkiye sahip olduğu saptanmıştır (p<0,05). Sonoelastografi (SEG) ölçümlerinde kıkırdakta anlamlı düzeyde yumuşama tespit edilmiştir (p<0,05). Distal femoral kartilaj değerlendirme açısının suprapatellar veya infrapatellar oluşunun anlamlı fark oluşturmadığı saptanmıştır (p>0.05). Obez çocuklarda kıkırdak dejenerasyonunun kontrol grubuna göre anlamlı olarak fazla olduğu tespit edilmiştir (p<0,05). Sonuç: Obez çocuklarda, özellikle kız cinsiyette ve yaş arttıkça distal femoral kartilaj kalınlık ölçümlerinde tüm sahalarda anlamlı incelme tespit edilmiştir. Obez çocuklarda distal femoral kartilajın shear wave elastografi ile değerlendirilmesinde, strain incelemeyle uygun olacak şekilde kartilaj sertliğinde istatistiksel olarak anlamlı yumuşama olduğu tespit edilmiştir. Obez çocuklarda, kontrol grubuna kıyasla anlamlı düzeyde kıkırdak dejenerasyonu olduğu ortaya konulmuştur. Çalışma verilerinin ışığında obezitenin, çocuk yaş grubunda distal femoral kıkırdak incelmesi ve dejenerasyonu açısından korunulması gereken ve önlenebilir bir risk faktörü olduğu görülmektedir.
Objective: To determine the role of ultrasonography and elastography in detecting joint cartilage changes among obese children and to provide baseline data for future diagnoses of other degenerative diseases. Materials and Methods: The study was initiated with the approval of the Kırıkkale University Medical Faculty Ethics Committee. It was planned as a prospective cross-sectional study. The study included 75 normal-weight and 75 obese (total 150) children, and bilateral distal femoral cartilage was evaluated in each child. The thickness measurement and degeneration findings were evaluated in both distal femoral cartilages using the suprapatellar and infrapatellar methods with B-mode ultrasound examination. Qualitative and quantitative evaluation of cartilage elasticity was performed with shear wave elastography and strain elastography. For statistical analysis, the SPSS 21.0 package program was used. Results: The mean age was 12.68 in the control group and 13.12 in the patient group. It was found that BMI did not have a statistically significant effect on right and left infrapatellar cartilage thicknesses (p>0.05). In contrast, age and gender significantly affected right and left infrapatellar cartilage thickness (p<0, 05). The difference between distal femoral cartilage thicknesses according to gender was statistically significant (p<0.05). While BMI did not have a statistically significant effect on the left distal femoral cartilage thickness measured by the suprapatellar method (p>0.05), it was found that age and gender had a statistically significant effect on the cartilage thickness measured by the right and left suprapatellar method (p<0.05). Significant softening was detected in the cartilage in sonoelastography (SEG) measurements (p<0.05). It was determined that there was no significant difference between the suprapatellar or infrapatellar approach for evaluating the distal femoral cartilage (p>0.05). Cartilage degeneration was found to be significantly higher in obese children compared to the control group (p<0.05). Conclusion: In obese children, especially in the female gender, and with increasing age, significant thinning was found in all distal femoral cartilage measurements. In the shear wave evaluation of the distal femoral cartilage in obese children, a statistically significant softening in cartilage stiffness was determined in parallel with strain examination. Obese children showed significant cartilage degeneration compared to the control group. In light of the study data, it is seen that obesity is a preventable risk factor for distal femoral cartilage thinning and degeneration in the pediatric age group.
Objective: To determine the role of ultrasonography and elastography in detecting joint cartilage changes among obese children and to provide baseline data for future diagnoses of other degenerative diseases. Materials and Methods: The study was initiated with the approval of the Kırıkkale University Medical Faculty Ethics Committee. It was planned as a prospective cross-sectional study. The study included 75 normal-weight and 75 obese (total 150) children, and bilateral distal femoral cartilage was evaluated in each child. The thickness measurement and degeneration findings were evaluated in both distal femoral cartilages using the suprapatellar and infrapatellar methods with B-mode ultrasound examination. Qualitative and quantitative evaluation of cartilage elasticity was performed with shear wave elastography and strain elastography. For statistical analysis, the SPSS 21.0 package program was used. Results: The mean age was 12.68 in the control group and 13.12 in the patient group. It was found that BMI did not have a statistically significant effect on right and left infrapatellar cartilage thicknesses (p>0.05). In contrast, age and gender significantly affected right and left infrapatellar cartilage thickness (p<0, 05). The difference between distal femoral cartilage thicknesses according to gender was statistically significant (p<0.05). While BMI did not have a statistically significant effect on the left distal femoral cartilage thickness measured by the suprapatellar method (p>0.05), it was found that age and gender had a statistically significant effect on the cartilage thickness measured by the right and left suprapatellar method (p<0.05). Significant softening was detected in the cartilage in sonoelastography (SEG) measurements (p<0.05). It was determined that there was no significant difference between the suprapatellar or infrapatellar approach for evaluating the distal femoral cartilage (p>0.05). Cartilage degeneration was found to be significantly higher in obese children compared to the control group (p<0.05). Conclusion: In obese children, especially in the female gender, and with increasing age, significant thinning was found in all distal femoral cartilage measurements. In the shear wave evaluation of the distal femoral cartilage in obese children, a statistically significant softening in cartilage stiffness was determined in parallel with strain examination. Obese children showed significant cartilage degeneration compared to the control group. In light of the study data, it is seen that obesity is a preventable risk factor for distal femoral cartilage thinning and degeneration in the pediatric age group.
Açıklama
Tıp Fakültesi, Radyoloji Ana Bilim Dalı
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology, Radyoloji ve Nükleer Tıp
