The prevalence and clinical relevance of incidental findings (IF(s)) on imaging assessing the pelvis in children has not been well documented.
Three-thousand two-hundred thirty-one children (mean age 10.2 (range 8.6–12.9) years) were evaluated with MRI of the hips, pelvis, and lumbar spine, as part of a prospective population-based pediatric cohort study. Scans were reviewed by trained medical staff for abnormalities. IFs were categorized by clinical relevance and need for further clinical evaluation.
8.3% (n = 267) of children featured at least one IF. One or more musculoskeletal IFs were found in 7.9% (n = 254) of children, however, only 0.8% (n = 2) of musculoskeletal IFs required clinical evaluation. Most frequent abnormalities were simple bone cysts 6.0% (n = 195), chondroid lesions 0.6% (n = 20), and perineural cysts 0.5% (n = 15). Intra-abdominal IFs were detected in 0.5% (n = 17) of children, with over half (n = 9) of these requiring evaluation. The three most common intra-abdominal IFs were a duplex collecting system 0.09% (n = 3), significant ascites 0.06% (n = 2), and hydroureteronephrosis 0.06% (n = 2).
IFs on MRI of the lower abdominal and hip region are relatively common in children aged 8–13 years, most of these can be confidently categorized as clinically irrelevant without the need for additional clinical or radiologic follow up.
Our research contributes greatly to the knowledge of the prevalence of (asymptomatic) pathology in children. We evaluated MR images of 3231 children, covering hip joints, pelvic skeleton, lower and mid-abdomen, and lumbar and lower thoracic spine as part of a population study.
One or more musculoskeletal incidental finding were found in 7.9% of children. Most of these can be confidently categorized as clinically irrelevant without the need for additional follow up. However 0.8% of musculoskeletal findings required further evaluation.
Intra-abdominal incidental findings were detected in 0.5% of children, with over half of the abdominal and urogenital findings requiring further evaluation.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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No financial assistance was received in support of the study.
The authors declare no competing interests.
Ethics approval and consent to participate
The Erasmus University Medical Center review board approved of the study and parents or legal guardians of the children provided written informed consent. In accordance with Dutch Law, children aged 12 years and older provided written informed consent themselves as well.
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de Vreede, D.K., Bessems, J.H.J.M., Dremmen, M.H.G. et al. The prevalence of incidental findings on pelvis MRI of 8–13-year-old children. Pediatr Res (2022). https://doi.org/10.1038/s41390-022-02259-6