Ultrasound Findings of Joints in Young, Healthy Individuals: Incidental Pathology

Study Highlights

The authors explored the prevalence of ultrasound pathology of joints, entheses, bursae, and tendons in healthy young people (N=51; median age, 23.7 years).
Effusion in at least one medium or large joint was found in 72.6% of participants. The number of hours dedicated to sports per week was associated with knee effusion (p = 0.017).
Entheseal anomaly was found in 27.5% of the participants. Body mass index and fat mass index were associated with enthese pathology (p = 0.015 and p = 0.026, respectively). Biceps tendon effusions were found in 13.7% of participants.
This is the first study to examine ultrasound outcomes in healthy young people. Healthcare providers should be aware of the high prevalence of incidental sonographic pathology in young, healthy, active patients and should interpret these findings with caution.

Aim

The purpose of this study was to determine the prevalence of ultrasound findings of joints, entheses, bursae, and tendons in large and medium-sized joints of young, healthy individuals.

Methods

Ultrasound evaluation of large and medium-sized joints, bursae, tendons, and entheses was performed in healthy individuals under 30 years of age.

Participants also underwent bioelectrical impedance analysis and performed supervised weight training to determine maximal strength.

The prevalence of ultrasound findings was calculated and a binary logistic regression model was applied to evaluate the factors associated with the present findings.

The enthesis is defined as the region where a tendon, ligament, joint capsule or muscle fascia attaches to the bone. It constitutes a transition tissue whose function, in addition to anchoring soft tissues, is to transfer the stress of these fixation areas to the adjacent bone, and vice versa.

Results

Fifty-one healthy individuals (52.9% female) with a mean age of 23.7 years were included in this study.

Joint effusion was observed in at least one joint in 72.6% of individuals (n = 37) and enthese pathology was detected in at least one enthesis in 27.5% (n = 14).

A binary logistic regression model indicated a significant association between reported hours of sports activity per week and the prevalence of knee effusion (p = 0.017).

Additionally, associations were observed between entheseal pathology in at least one entheseal site and body mass index (BMI) (p = 0.015) as well as fat mass index (p = 0.026).

Conclusions

Joint effusion in large and medium-sized joints, as well as entheseal hyperperfusion, bursal effusion, and tendon sheath effusion, are found in healthy individuals.

Hours of sports activity per week, BMI and fat mass index showed significant associations with findings in joints and entheses.

Ultrasound Findings of Joints in Young, Healthy Individuals: Incidental Pathology

Incidental ultrasound pathology is highly prevalent in young, healthy, and active patients, highlighting the importance of clinical correlation and judicious use of imaging modalities in the diagnostic evaluation of musculoskeletal complaints in asymptomatic individuals.