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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:701-705 • 0278-4297

Sonographic Nomogram of the Fetal Calf Between 15 and 42 Weeks’ Gestation Using 3-Dimensional Sonography

Reli Hershkovitz, MD and Ronnie Tepper, MD

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Be’er Sheva, Israel (R.H.); and Meir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Kfar Saba, Israel (R.T.).

Address correspondence to Reli Hershkovitz, MD, Ultrasound Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, 84101 Be’er Sheva, Israel. E-mail: ralikah{at}bgumail.bgu.ac.il

Objective. The purpose of this study was to establish a new reference growth chart of calf muscle biometric measurements throughout gestation in normal singleton pregnancies. Methods. A prospective cohort study was designed. One hundred pregnant women were included in the study and assessed by 3-dimensional sonography. Excluded were those with multiple pregnancies, congenital anomalies, abnormal karyotypes, and polyhydramnios or oligohydramnios. Three-dimensional multiplanar sonographic images were used to measure the calf muscles: soleus, gastrocnemius, popliteal, peroneus longus, and tibialis posterior. Results. Calf muscle widths increased with increasing gestational age (R2 = 0.857; P < .0001), and the ratio between calf muscles and the tibia increased as well (R2 = 0.356; P = .001). Conclusions. The data provide a nomogram of calf width with a direct correlation between muscle growth and gestational age. This nomogram can offer a basis for normal calf development and may assist in distinguishing between different etiologies leading to clubfoot and other joint contractures associated with calf atrophy.

Key Words: calf • soft tissue • 3-dimensional sonography

Abbreviations: 3D, 3-dimensional

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.