ArticlePediatric radiology2026
Ultrasound-guided core needle joint biopsies in children: pathological findings, diagnostic performance, and clinical relevance.
Article in Pediatric radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
backgroundSynovial-joint abnormalities in children can be caused by different conditions, including autoimmune arthritis, infection, and neoplasm. An ultrasound-guided biopsy targeting the synovial membrane can aid in determining the etiology when the cause is unclear.
objectiveTo determine the diagnostic performance, findings, and outcomes of ultrasound-guided joint biopsy in children. MATERIALS AND
methodThis is a retrospective study on patients who underwent ultrasound-guided joint biopsy from May 2000 to December 2024. Patient demographics, clinical information, imaging, procedure details, pathology findings, adverse events, and clinical outcomes were collected and reviewed.
resultsThirty-one patients (25 females) with a mean age of 10.2 years underwent 34 biopsies. Presenting symptoms were pain (33/34), mobility issues (33/34), and swelling (20/34). Effusion (19/28), joint capsule thickening (24/28), and contrast enhancement (20/28) were the most common MRI findings, while joint capsule thickening (29/29) and effusion (19/29) were the most frequent ultrasound findings. The most common joints biopsied were the hip (16/34), knee (9/34), and ankle (4/34). Core needle biopsy was performed in all cases. The mean number of passes was 4.5 (SD 1.8), obtaining a mean of 4.1 cores (SD 1.9). Biopsy was diagnostic in 20/34 (59% [CI 41-76%]) joints, and only one patient required surgical biopsy. Synovitis was the most common diagnosis (14/34), followed by pigmented villonodular synovitis (2/34). No major adverse events were observed.
conclusionUltrasound-guided joint biopsy in children has moderate diagnostic performance; however, it can be clinically impactful, even when non-diagnostic, helping in joint disease management, potentially preventing surgery, with low adverse event incidence.
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