Ultrasound visualization of the deep fascia in children – measurement protocol

Czech version

Authors: A. Quittková ¹; T. Katolická ¹; K. Podlipná ¹; J. Katolický ¹; Z. Čech ¹; C. Pirri ²; C. Stecco ²; S. Machač ¹; M. Šafářová ¹
Authors‘ workplace: Klinika rehabilitace a tělovýchovného lékařství 2. LF UK a FNMH, Praha ¹; Department of Neurosciences, Institute of Human Anatomy, University of Padova, Italy ²
Published in: Rehabil. fyz. Lék., 33, 2026, No. 1, pp. 21-28.
Category: Review Article
doi: https://doi.org/10.48095/ccrhfl202621

Overview

Deep fascia is visualized on ultrasound imaging as a thin hyperechoic layer located at the interface between subcutaneous tissues and the underlying muscle. In recent years, there has been increasing interest in ultrasound assessment of the fascial system, particularly in relation to its role in movement biomechanics and in the pathophysiology of musculoskeletal disorders. The aim of this article is to describe a protocol for ultrasound imaging of the deep fascia of the lower limb in the pediatric population and to present a method for the standardized assessment of its thickness. The paper also summarizes key anatomical and methodological aspects essential for the correct interpretation of ultrasound images of the deep fascia and for obtaining reproducible measurement results. The article is based on findings from current literature focused on ultrasound evaluation of fasciae and on previously published ultrasound protocols used in adult populations. For pediatric examinations, a modified protocol was proposed, including eight predefined sites on the lower limb –⁠ four on the thigh and four on the lower leg. Ultrasound images are acquired with the patient in a standardized position, with particular emphasis on correct probe orientation and minimization of tissue compression. Measurement of fascial thickness is performed retrospectively on stored images within a defined region of interest (ROI) using ImageJ software. Ultrasound imaging represents an accessible, non-invasive, and reliable method for the evaluation of deep fascia of the lower limb –⁠ fascia lata and fascia cruris. The proposed standardized protocol enables systematic and reproducible assessment of the deep fascia in children and may contribute to expanding current knowledge of its physiology, development, and pathological changes.

Keywords:

Connective tissue – musculoskeletal system – ultrasonography – fascia thickness – fascia lata – crural fascia – imaging protocols

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Article was published in

Rehabilitation & Physical Medicine

2026 Issue 1

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