Ultrasound assessment of splenic length & spleen to left kidney ratio

Spleen is a hemopoietic organ which is capable of supporting elements of different systems. Ultrasound (US) may detect mild splenomegaly before it is clinically palpable. Racial differences in splenic length could result in incorrect interpretation of splenic measurements & such differences would make it difficult to standardized expected splenic length & to determine non- palpable splenic enlargement. Aim of the study: to determine whether there is a constant ratio of the length of the spleen to the left kidney which could used to diagnose splenomegaly without reference to a nomogram. This is a cross-sectional study conducted among a total of 280 children ranging in age from birth to 20 years. US were used to measure maximum splenic & left kidney lengths to obtain normal values for splenic length & to determine spleen to left kidney ratio. The results show that the spleen to left kidney ratio is strikingly constant with mean value of 1 and splenomegaly should be suspected in children if the spleen is more than 1.25 times longer than the adjacent kidney.