['To examine the usefulness of ultrasonography (USG) for monitoring paediatric localized scleroderma (LS).', 'A retrospective chart review of six paediatric patients who had USG of their LS.', 'USG detected several abnormalities in active lesions including increased blood flow, increased echogenicity and loss of subcutaneous fat. USG findings corresponded with clinical assessment, and documented regeneration of subcutaneous fat and reduction in lesion size during treatment. In one patient, USG was more sensitive than magnetic resonance evaluation.'] Is ultrasonography a sensitive tool for monitoring localized scleroderma?