ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Gastroenterology, Hepatology and Nutrition
Volume 13 - 2025 | doi: 10.3389/fped.2025.1624070
Pocket-sized hand-held ultrasound for evaluating pediatric functional constipation by both novice and expert clinicians
Provisionally accepted
- 1Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Ariel University, Ariel, Israel
- 2Department of Pediatric Emergency Medicine, Schneider Childrens Medical Center of Israel, Petach Tikva, Israel
- 3Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Background/Objectives: Pediatric functional constipation (PFC) is a global health concern. This study evaluates the utility of pocket-sized ultrasound (PsUS) as a tool for assessing PFC among clinicians with varying levels of ultrasound (US) experience. We assessed the validity of PsUS in measuring transverse rectal diameter (TRD) and rectal anterior wall thickness (RAWT) compared to conventional US and to evaluate agreement between expert and novice clinicians. Methods: In this cross-sectional study, TRD and RAWT were measured using conventional US and PsUS in 52 children (PFC: n = 28; non-constipated: n = 24), aged 4-14 years. Measurements were performed by an experienced and a novice clinician. Agreement and validity were assessed using intraclass correlation coefficients (ICCs), and diagnostic accuracy was evaluated using receiver operating characteristic (ROC) analysis. Results: High agreement was found between the experienced and novice clinicians in assessing PFC using conventional US (ICC for TRD = 0.98, 95% CI: 0.98-0.99; ICC for RAWT = 0.98, 95% CI: 0.97-0.99) and PsUS (ICC for TRD = 0.99, 95% CI: 0.97-0.99; ICC for RAWT = 0.97, 95% CI: 0.96-0.98). PsUS showed robust validity compared to conventional US (ICCs of 0.96 for TRD and 0.87 for RAWT). ROC analysis showed high diagnostic accuracy for PsUS at TRD (area under the curve (AUC) = 0.88, cut-off 30.25mm) and RAWT (AUC = 0.91, cut-off 2.05mm). Conclusions: These results suggest PsUS is a valid and reliable tool for assessing PFC, that can be used by clinicians with varying levels of US experience.
Keywords: Pediatric Functional Constipation, Pocket-sized ultrasound, point-of-care ultrasound, Rectal wall thickness, transverse rectal diameter
Received: 06 May 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Waissman, Berant, Amir, Reif and Springer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Pola Waissman, Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Ariel University, Ariel, Israel
Shmuel Springer, Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Ariel University, Ariel, Israel
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.